Recognising, Treating Tension Headache


Tension headache is one of the most common forms of headaches and it can occur at any age. It is pain or discomfort in the head, scalp, or neck, usually associated with muscle tightness in these areas.

These headaches may occur only occasionally in response to a stressful event, but may also be chronic, occurring frequently. Some tension headaches are nearly constant, with daily pain that may vary in intensity. It was renamed as Tension Type Headaches by the International Headache Society.

What it feels like

Tension-type headache pain is usually described as a dull pressure (not throbbing) that feels like a tight band or vise all over the head and not just in one point or one side. Usually worse in the scalp, temples, or back of the neck, pain from tension headache may radiate to the shoulders.

The pain could occur as an isolated event, constantly, or daily, lasting for 30 minutes to seven days and may be triggered by or worsened with stress, fatigue, noise, or glare. The pain could affect your sleep but usually does not cause nausea or vomiting.


Tension headaches occur when neck and scalp muscles become tense and such muscle contractions can be a response to stress, anxiety, depression or a head injury. Activities that cause the head to be held in one position for a long time without moving can also cause a tension headache. Such activities include typing or other computer work, fine work with the hands, and using equipment such as a microscope.

Sleeping in a cold room or sleeping with the neck in an abnormal position may also trigger tension headache. Other triggers of tension headaches include: Fatigue or overexertion, dental problems, jaw-clenching/teeth-grinding, eye strain, excessive alcohol intake, caffeine (excessive or withdrawal), cold, flu or sinus infections.

Risk factors

Your risk of getting a tension headache increases with depression, anxiety, gender (more common in women), teeth-clenching or grinding, sleep apnea, medications, sleep disruption, low physical activity, being overweight and smoking.

What to do

To rule out other serious disorders that can cause headaches, you should see your doctor if the pain is severe, persistent, or if other symptoms are present with the headache. Headaches that disturb your sleep, occur whenever you are active, or that are recurrent or chronic may require examination and treatment by a physician. Otherwise, the goal is to treat your tension headache symptoms right away, and to prevent headaches by avoiding or changing your triggers.

Self care

You may put an ice pack or heat pack on your head or neck to ease discomfort. If necessary, take a warm shower, with water running over tense muscles, and you can also massage your temples and neck.

Keep warm if the headache is associated with cold. Using a different pillow or changing sleeping positions could also bring relief. Remember to reduce or avoid things that give you stress and ensure you include relaxation, get sufficient sleep and rest.

Use pain medication, but be aware that continuous use of some over-the-counter medication may create rebound pain when you stop taking the drug. Using these medicines too much can also cause headaches.

Prevention through lifestyle changes

Learn to recognise what provokes a tension headache and work toward resolution. Find ways to establish regular exercise programme, improve your posture and adjust your schedule to have adequate time for rest and relaxation. Take short breaks from sedentary tasks. Keep a diary, marking when headaches occur and what you were doing before they started. Avoid or minimise stressful situations

Physiotherapists can help

After conducting a thorough examination that includes a review of your health history, your therapist will ask you questions and perform tests to determine the most likely cause of your headaches. Your therapist might also ask you to recall if you had previous injuries to your neck, head, or jaw; and about the location, nature, and behaviour of your pain and other symptoms. The physiotherapist will work with you to design a plan of care to meet your goals of treatment.