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Managing tension headaches at home

Tension-type headache - self-care; Muscle contraction headache - self-care; Headache - benign - self-care; Headache - tension- self-care; Chronic headaches - tension - self-care; Rebound headaches - tension - self-care

A tension headache causes pain or discomfort in your head, scalp, or neck. Tension headache is a common type of headache. It can occur at any age, but it is most common in teens and adults.

A tension headache occurs when neck and scalp muscles become tense or contract. The muscle contractions can be a response to stress, depression, a head injury, or anxiety.

When You Have a Tension Headache

Hot or cold showers or baths may relieve a headache for some people. You may also want to rest in a quiet room with a cool cloth on your forehead.

Gently massaging your head and neck muscles may provide relief.

If your headaches are due to stress or anxiety, you may want to learn ways to relax.

Over-the-counter pain medicine, such as aspirin, ibuprofen, naproxen, or acetaminophen, may relieve pain. If you are planning to take part in an activity that you know will trigger a headache, taking pain medicine beforehand may help.

Avoid smoking and drinking alcohol.

Follow your health care provider's instructions about how to take your medicines. Rebound headaches are headaches that keep coming back. They can occur from overuse of pain medicine. If you take pain medicine more than 3 days a week on a regular basis, you can develop rebound headaches.

Be aware that aspirin and ibuprofen (Advil, Motrin) can irritate your stomach. If you take acetaminophen (Tylenol), do not take more than a total of 4,000 mg (4 grams) of acetaminophen a day to avoid liver damage. Taking acetaminophen with alcohol (3 or more drinks a day) also increases the risk of liver damage.

Preventing Tension Headaches

Knowing your headache triggers can help you avoid situations that cause your headaches. A headache diary can help. When you get a headache, write down the following:

  • Day and time the pain began
  • What you ate and drank over the past 24 hours
  • How much you slept
  • What you were doing and where you were right before the pain started
  • How long the headache lasted and what made it stop

Review your diary with your provider to identify triggers or a pattern to your headaches. This can help you and your provider create a treatment plan. Knowing your triggers can help you avoid them.

Lifestyle changes that may help include:

  • Use a different pillow or change sleeping positions.
  • Practice good posture when reading, working, or doing other activities.
  • Exercise and stretch your back, neck, and shoulders often when typing, working on computers, or doing other close-up work.
  • Get more vigorous exercise. This is an exercise that gets your heart beating fast. (Check with your provider about what kind of exercise is best for you.)
  • Have your eyes checked. If you have glasses, use them.
  • Learn and practice stress management. Some people find relaxation exercises or meditation helpful.

If your provider prescribes medicines to prevent headaches or help with stress, follow instructions exactly on how to take them. Tell your provider about any side effects.

When to Call the Doctor

Call 911 or the local emergency number if:

  • You are experiencing "the worst headache of your life."
  • You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms with a headache before.
  • You have a fever with your headache.
  • A headache starts suddenly or is explosive in nature.

Schedule an appointment or contact your provider if:

  • Your headache pattern or pain changes.
  • Treatments that once worked no longer help.
  • You have side effects from your medicine.
  • You are pregnant or could become pregnant. Some medicines should not be taken during pregnancy.
  • You need to take pain medicines more than 3 days a week.
  • Your headaches are more severe when lying down.

References

Digre KB. Headaches and other head pain. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 367.

Garza I, Robertson CE, Smith JH, Whealy MA. Headache and other craniofacial pain. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 102.

Rozental JM. Tension-type headache, chronic tension-type headache, and other chronic headache types. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 20.

  • Tension headache

    Animation

  •  

    Tension headache - Animation

    Do you often feel pain or discomfort in your head, scalp, or neck? Do your muscles get tight in these areas? If the answer is yes, you may suffer from tension headaches. Tension headaches are one of the most common forms of headaches. You can get them at any age, but they mostly happen in adults and adolescents. Tension headaches occur when your neck and scalp muscles get tense, or contract. These muscle contractions can typically be a response to stress, depression, a head injury, or anxiety. Often, you can get a tension headache when you hold your head in one position for a long time without moving it. Prime examples are typing at a computer, doing fine work with your hands, and using a microscope. You can even get a tension headache from sleeping in a cold room, from a cold, from drinking too much alcohol or caffeine, or from dental problems. If you have tension headaches, you'd probably describe your pain as being dull, pressure-like and not throbbing. You may say it feels like a tight band or vice around your head. It may be all over, not just in one point or on one side of your head or it could be worse in your scalp, temples, or the back of your head, and maybe even your shoulders. Your doctor will ask you about what may be triggering your headaches. In fact, it's a good idea to keep a diary when you get headaches, and take it with you when you see your doctor. When you get a headache, write down the day and time the pain began. Include notes about what you ate and drank in the previous 24 hours, how much you slept and when, and what was going on in your life immediately before the pain started. Write down how long the headache lasted, and what made it stop. For some people, taking hot or cold showers or baths may relieve a headache. You may need to make lifestyle changes if you have a lot of tension headaches. For example, you made need to change your sleep habits, usually you'll need more sleep, get more exercise, and stretch your neck and back muscles. Your doctor may tell you to take over-the-counter painkillers, such as aspirin, ibuprofen, or acetaminophen if relaxation techniques do not work. If you plan to do something you know will trigger a headache, taking one of these painkillers beforehand may help. Your doctor may prescribe muscle relaxants, or other medicines, but after a while you may start getting rebound headaches because you are taking medicines. The best thing you can do if you get a lot of tension headaches is to lower your stress level, and the tension level in your head, neck, and shoulder muscles. Take breaks at the computer, learn to relax, avoid stressful situations, and make quiet time for yourself.

  • Tension-type headache - illustration

    The most common cause of tension-type headaches is muscle contraction in the head, neck or shoulders.

    Tension-type headache

    illustration

  • Headache - illustration

    Headaches are usually caused by either muscle tension, vascular problems, or both. Migraines are vascular in origin, and may be preceded by visual disturbances, loss of peripheral vision, and fatigue. Most headaches can be relieved or ameliorated by over-the-counter pain medications.

    Headache

    illustration

  • CT scan of the brain - illustration

    A CT or CAT scan (computed tomography) is a much more sensitive imaging technique than X-ray, allowing high definition not only of the bony structures, but of the soft tissues. Clear images of organs such as the brain, muscles, joint structures, veins and arteries, as well as anomalies like tumors and hemorrhages may be obtained with or without the injection of contrasting dye.

    CT scan of the brain

    illustration

  • Migraine headache - illustration

    Symptoms of a migraine attack may include heightened sensitivity to light and sound, nausea, auras (loss of vision in one eye or tunnel vision), difficulty of speech and intense pain predominating on one side of the head.

    Migraine headache

    illustration

  • Tension headache

    Animation

  •  

    Tension headache - Animation

    Do you often feel pain or discomfort in your head, scalp, or neck? Do your muscles get tight in these areas? If the answer is yes, you may suffer from tension headaches. Tension headaches are one of the most common forms of headaches. You can get them at any age, but they mostly happen in adults and adolescents. Tension headaches occur when your neck and scalp muscles get tense, or contract. These muscle contractions can typically be a response to stress, depression, a head injury, or anxiety. Often, you can get a tension headache when you hold your head in one position for a long time without moving it. Prime examples are typing at a computer, doing fine work with your hands, and using a microscope. You can even get a tension headache from sleeping in a cold room, from a cold, from drinking too much alcohol or caffeine, or from dental problems. If you have tension headaches, you'd probably describe your pain as being dull, pressure-like and not throbbing. You may say it feels like a tight band or vice around your head. It may be all over, not just in one point or on one side of your head or it could be worse in your scalp, temples, or the back of your head, and maybe even your shoulders. Your doctor will ask you about what may be triggering your headaches. In fact, it's a good idea to keep a diary when you get headaches, and take it with you when you see your doctor. When you get a headache, write down the day and time the pain began. Include notes about what you ate and drank in the previous 24 hours, how much you slept and when, and what was going on in your life immediately before the pain started. Write down how long the headache lasted, and what made it stop. For some people, taking hot or cold showers or baths may relieve a headache. You may need to make lifestyle changes if you have a lot of tension headaches. For example, you made need to change your sleep habits, usually you'll need more sleep, get more exercise, and stretch your neck and back muscles. Your doctor may tell you to take over-the-counter painkillers, such as aspirin, ibuprofen, or acetaminophen if relaxation techniques do not work. If you plan to do something you know will trigger a headache, taking one of these painkillers beforehand may help. Your doctor may prescribe muscle relaxants, or other medicines, but after a while you may start getting rebound headaches because you are taking medicines. The best thing you can do if you get a lot of tension headaches is to lower your stress level, and the tension level in your head, neck, and shoulder muscles. Take breaks at the computer, learn to relax, avoid stressful situations, and make quiet time for yourself.

  • Tension-type headache - illustration

    The most common cause of tension-type headaches is muscle contraction in the head, neck or shoulders.

    Tension-type headache

    illustration

  • Headache - illustration

    Headaches are usually caused by either muscle tension, vascular problems, or both. Migraines are vascular in origin, and may be preceded by visual disturbances, loss of peripheral vision, and fatigue. Most headaches can be relieved or ameliorated by over-the-counter pain medications.

    Headache

    illustration

  • CT scan of the brain - illustration

    A CT or CAT scan (computed tomography) is a much more sensitive imaging technique than X-ray, allowing high definition not only of the bony structures, but of the soft tissues. Clear images of organs such as the brain, muscles, joint structures, veins and arteries, as well as anomalies like tumors and hemorrhages may be obtained with or without the injection of contrasting dye.

    CT scan of the brain

    illustration

  • Migraine headache - illustration

    Symptoms of a migraine attack may include heightened sensitivity to light and sound, nausea, auras (loss of vision in one eye or tunnel vision), difficulty of speech and intense pain predominating on one side of the head.

    Migraine headache

    illustration

Self Care

 
 

Review Date: 12/31/2023

Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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