Tension-type headache; Episodic tension-type headache; Muscle contraction headache; Headache - benign; Headache - tension; Chronic headaches - tension; Rebound headaches - tension
A tension headache is the most common type of headache. It is pain or discomfort in the head, scalp, or neck, and is often associated with muscle tightness in these areas.
Tension headaches occur when neck and scalp muscles become tense or contract. The muscle contractions can be a response to stress, depression, head injury, or anxiety.
They may occur at any age, but are most common in adults and older teens. It is slightly more common in women and tends to run in families.
Any activity that causes the head to be held in one position for a long time without moving can cause a headache. Activities may include typing or other computer work, fine work with the hands, and using a microscope. Sleeping in a cold room or sleeping with the neck in an abnormal position may also trigger a tension headache.
Other triggers of tension headaches include:
Tension headaches can occur when you also have a migraine. Tension headaches are not associated with brain diseases.
The headache pain may be described as:
The pain may occur once, constantly, or daily. Pain may last for 30 minutes to 7 days. It may be triggered by or get worse with stress, fatigue, noise, or glare.
You may have difficulty sleeping. Tension headaches usually do not cause nausea or vomiting.
People with tension headaches try to relieve pain by massaging their scalp, temples, or the bottom of the neck.
If your headache is mild to moderate, without other symptoms, and responds to home treatment within a few hours, you may not need further examination or testing.
With a tension headache, there are usually no problems with the nervous system. But tender points (trigger points) in the muscles are often found in the neck and shoulder areas.
The goal is to treat your headache symptoms right away and to prevent headaches by avoiding or changing your triggers. A key step in doing this involves learning to manage your tension headaches at home by:
Many people can treat their tension headaches with conservative therapy, such as relaxation or stress-management training, including:
When needed, medicines that may relieve a tension headache include:
Be aware that:
If these medicines do not help, talk to your provider about prescription medicines.
Tension headaches often respond well to treatment. But if the headaches are long-term (chronic), they can interfere with life and work.
Call 911 if:
Also, contact your provider if:
Learn and practice stress management. Some people find relaxation exercises or meditation helpful. Biofeedback may help you improve the effect of doing relaxation exercises, and may be helpful for long-term (chronic) tension headache.
Tips to prevent tension headaches:
Massaging sore muscles may also help.
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Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 2018;17(1):75-83. PMID: 29174963 www.ncbi.nlm.nih.gov/pubmed/29174963/.
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.BACK TO TOP
Review Date: 11/9/2021
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 Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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