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Tension Headaches


What is a Tension Headache?

A tension headache is a head pain that results from muscle tightening (contraction) in the neck and head. The muscle contraction leads to a slight decrease in blood flow to the surrounding areas and an irritation of pain fibers in the skin, muscles, and blood vessel walls.

What Causes It?

The causes are unknown. Anxiety, depression, and emotional conflicts are often associated with tension headaches. Headaches may also result from muscle strain associated with injury to the neck muscles. An abnormality in the bones at the back of the neck (cervical vertebrae) or in the area where the mouth opens and closes (temporomandibular joint) may also put tension on the surrounding muscles and lead to a tension headache. On occasion, a child who has been incorrectly fitted with glasses may suffer form a tension headache due to eye muscle strain.

What are the Common Symptoms?

More than 90 percent of tension headaches are on both sides of the head. The headache is often described as a pressure or bandlike sensation around the head. The dull, steady pain builds gradually and is often intense at the end of the day. In some individuals, the headache continues day and night. Even after sleep, the headache may still be present.

Is it Contagious?

NO!

How Long will it Last?

Tension headaches may last a few hours, several days, weeks, or even months.

How is it Treated?

Treatment for this problem consists of two important parts: (1) what you can do and (2) what your health care provider can do.

What can you do?
There are many measures one can try to reduce the pain.

  1. Some people find relief by applying heat to the area of the head where the pain is most severe. Apply heat in the form of a dry towel warmed in the oven or use a heating pad set on a low setting. Other people gain relief by applying an ice bag wrapped in a towel to the painful area.
  2. A gentle fingertip massage over the area just in front of and above the ears (temporal area) may reduce the pain.
  3. Lying down and relaxing may also help to decrease the pain. Many people find concentrating on a soothing thought or image while taking slow, deep breaths helps them relax.
  4. Record on a calendar the date of the headache, the time it started and ended, and the amount of medication you took. Remember to bring this record with you on follow-up visits to your health care provider. It will help in your treatment.

What can your health provider do?
If the cause of the tension headache is a cervical vertebrae or temporomandibular joint problem, medical correction of the condition will be necessary. Incorrectly fitted eyeglasses must be refitted if they are the cause of tension headaches. A neck injury that is contributing to a tension headache can be helped with a supportive collar, which allows the muscles in the neck to rest and relax.

Medications are needed for some individuals. Your health care provider may prescribe one or more of the following medications.

  • Analgesics - These medications reduce the pain of a tension headache.
  • Muscle Relaxants - These medications aid in relaxation by causing sedation and decreasing anxiety. They have little or no direct effect on relaxing the muscles of the head and neck that contribute to the headache. Some of these medications can become addictive.

Can it be Prevented?

Because tension headaches may recur in some individuals for years and because continual use of medication can lead to serious side effects, prevention is a key aspect in the management of tension headaches.

Tension headaches are often a response to stress, anxiety, and emotional conflict in a person's life. It is important to find ways to reduce these conflicts. Regular exercise (e.g., walking, biking, swimming) and relaxation techniques (e.g., yoga, meditation) may help you. Exercise and relaxation not only reduce stress but also decrease the severity of head pain. A trained counselor can help provide assistance to identify the stresses in your life and make suggestions to resolve the problems.

Common Myths

It is a myth that tension headaches are inherited. However, people do imitate the stress reaction and responses of those around them. They may develop a tension headache as a result of ineffective stress management.

Follow-Up

It is important to return for your follow-up care as advised.

Resources

Call your local community center, YMCA, Dragon Wellness Center, or adult education program for information about classes in yoga, meditation, aerobic dance, or other exercise classes. Hendrix Health Center can assist you in an evaluation for stress and make a referral to a counselor for you.

Remember

Notify a clinician if you have any of the following:

  • Changes in vision
  • Numbness or tingling in your arms or legs
  • Sudden onset of a fever with a headache
  • Difficultly walking
  • Difficulty speaking
  • Marked change in severity of your headache
  • Questions concerning the symptoms you are experiencing

REFERENCE: Shamansky, S., Cecere, M.C., & Shellenberger, E. (1984). Primary Health Care Handbook: Guidelines for Patient Education. Boston: Little, Brown & Co.