Tension Headache: Symptoms, Causes and Relief

What is a tension headache?

Tension-type headache is the most common type of headache worldwide. Most people get one at some point. For most, they’re occasional and mild, but some people get them very often.

Tension headache symptoms

• Pressing or tightening pain, often described as a band around the head
• Usually on both sides, across the forehead, temples or back of the head
• Mild to moderate, rather than severe
• Not made worse by routine activity like walking or stairs
• No nausea or vomiting
• Tender muscles in the neck, shoulders or scalp

Attacks can last from 30 minutes to several days.

Episodic and chronic

Episodic tension-type headache happens on fewer than 15 days a month. Chronic tension-type headache happens on 15 or more days a month for more than three months, and has a bigger effect on daily life.

Common triggers

• Stress and worry (often called stress headaches)
• Poor or short sleep
• Long periods at screens or in one posture
• Missed meals and dehydration
• Eye strain
• Jaw clenching or teeth grinding

Relief and prevention

• Regular sleep and meals
• Regular exercise, which reduces headache frequency for many people
• Stress management: relaxation, breathing techniques, mindfulness or cognitive behavioural therapy
• Breaks from screens and changes in posture
• Heat or massage for tight neck and shoulder muscles
• Physiotherapy if neck problems contribute
• Pain relief from a pharmacy for occasional headaches, used on no more than a few days a week. Ask your pharmacist.

Watch for medication-overuse headache

Taking pain relief for headache on many days a month can make headaches more frequent. If you’re using it more than a couple of days a week, see a GP.

When to see a doctor

See a GP if headaches are frequent, changing, or affecting your life. Call 000 for a sudden severe headache, headache with weakness or confusion, or headache with fever and a stiff neck.

References

1. Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021;7(1):24.
2. . Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
3. Diener HC, Dodick D, Evers S, et al. Pathophysiology, prevention, and treatment of medication overuse headache. Lancet Neurol. 2019;18(9):891-902.
4. healthdirect. Headaches.