Tension Headache – Its Causes, Symptoms, & Treatment

Tension headaches are one of the most common types of headaches experienced by the majority of people worldwide. Tensions headaches are characterized as dull pain or tightness around the forehead and the back of the head or neck. A clinical study recorded that 80% of the adults in the U.S suffer from tension headaches. Moreover, 3% of them have chronic daily tension headaches.

Often, the pressure created by tension headache feels like a tight band of pain contracting and squeezing the muscles of the forehead. Tension headaches are usually referred to as stress headaches as well. Some of the common causes of a tension headache include excessive emotional and physical stress, anxiety, dehydration, lifestyle activities, and food habits.


It is essential to understand and identify the underlying cause to treat the condition entirely and minimize the risk of recurrent tension headaches. Some of the treatments include stress management, medications, behavioral therapy, lifestyle modification, and acupuncture. Today’s article will highlight the features of a tension headache. Furthermore, we will discuss the causes, symptoms, and treatment of tension headache.

What is a tension headache?

Tensions headache, also known as stress headache is the most common type of facial pain. It can occur in variable intensities leading to mild, moderate, and severe episodes of pain in the eyes, head, and neck. Often, tension headache is described as a feeling of wearing a tight band around the forehead.

Tensions headaches are usually episodic and occur at least once or twice per month on an average. Chronic tension headaches affect almost around 3% of the U.S population. Such episodes last for more than 15 days per month. (1)

What causes a tension headache?

Typically, tension headaches are caused by muscle contractions in the regions of the head and neck. Foods, activities, and stress trigger such contractions. Watching tv or computer screen for a long time can also trigger a tension headache. (2) Some other causes of a tension headache include –

  • Alcohol consumption
  • Dryness of the eye
  • Muscle fatigue
  • The chronic habit of smoking
  • Cold or flu
  • Sinus infection
  • Excessive caffeine intake
  • Poor posture
  • Emotional and physical stress (3)
  • Lack of sleep
  • Dehydration and skipping meals

What are the symptoms of a tension headache?

Typical symptoms of a tension headache include –

  • A constant dull aching pain
  • Tightness and pressure around the forehead
  • Tenderness around the forehead and scalp
  • Burning of the eyes (4)

The intensity of the headache can vary from mild, moderate to severe, depending on the type of cause. Severe tension headache is characterized by throbbing pain on one or both sides of the head. Often, people might confuse severe tension headaches with a migraine.

Tension headaches may also lead to episodes of nausea, vomiting, and sensitivity to loud noise or bright light. Depending on the frequency of headache, a tension headache can be classified into the following –

Infrequent Episodic tension headache

Such headaches last 30 minutes to a week and occur less than 12 times in a month for three consecutive months.

Frequent episodic tension headache

Such headaches last for about 30 minutes and can occur several times a week. However, episodic headaches occur less than 15 days in a month for at least three consecutive months. (5)

Chronic tension headache

Occasional headaches can often turn into chronic tension headaches if they occur more than 15 days in a month for three consecutive months.

A note on Tension Headache Vs. Migraine

Often, tension headaches are difficult to differentiate from migraines. However, a few considerations may help you to identify the type of headache –

  • Unlike migraine, tension headaches are not associated with visual disturbances, nausea, and vomiting. (6)
  • Tension headaches are not aggravated by physical activity as compared to migraine.
  • Tension headaches are not associated with sensitivity to light and noise.

When should you see a doctor?

Usually, tension headaches can be treated with medication. However, if episodic headaches continue to reoccur more than two times a week, consult your doctor. Often, professional consultation can identify the pattern and cause behind the frequent episodes of tension headache. Additionally, you must seek emergency help for the following situations –

  • Severe and abrupt headache
  • Headache associated with fever, mental confusion, seizure, stiff neck, weakness, numbness, double vision, and difficulty in speaking.
  • A recent head injury leading to increased frequency of headache.
  • Stroke and aneurysm
  • Loss of consciousness

What is the treatment for tension headaches?

Frequent episodes of tension headache can point towards a severe underlying condition which often requires a CT scan and MRI for diagnosis. Treatment of tension headache depends on the underlying cause. Some of the conventional treatments of a tension headache may include –

Medication therapy and home care

Home care starts with balancing nutrition and water content in the body; it is essential to have a stable and balanced diet that includes equal proportions of proteins, vitamins, and minerals. Moreover, drink plenty of water to stay hydrated. (7)

Over-the-counter pain medications such as ibuprofen and aspirin can help to get rid of the tension headache. In some cases, where the pain relievers do not work, muscle relaxants may be prescribed to soothe the muscle contractions.

Supplemental therapy

Some supplemental therapies that help to relieve tension headache include –

  • Co-enzyme Q10
  • Butterbur
  • Magnesium and riboflavin supplements

Other ways of treating tension headache include-

  • Hot and cold ice packs – a heating pad or an ice pack can be used for five to ten minutes several times a day.
  • Hot shower bath
  • Improved posture
  • Eye and neck exercises (8)
  • Frequent breaks from tv or computer screens

Other treatments

Some of the alternative therapies for tension headache may include –

  • Stress management – relaxation therapies help effectively in coping with stress and relieving tension of the head, face, neck, and shoulder.
  • Biofeedback therapy – is also a type of relaxation therapy that teaches the individual to manage pain and stress in day to day life. (9)
  • Cognitive-behavioral therapy – is typically a talk therapy that helps to recognize the trigger factors of stress, anxiety, and tension.
  • Acupuncture – is an alternative therapy of stress relief that is performed by applying fine needles on the specific areas of the forehead and body.

What is the prognosis of a tension headache?

Infrequent episodic tension headaches are the easiest ones to be treated successfully. Usually, such headaches are treated with pain-relieving medications. The frequent and chronic type of tension headaches requires a combination of therapies depending on the underlying cause. It may typically take several months to successfully reduce the frequency of chronic tension headaches and provide complete relief.

How to prevent tension headaches?

The best way to prevent tension headache is to bring a change in the lifestyle –

  • Get enough sleep for a minimum of 6-7 hours. Additionally, do not oversleep as it might trigger a tension headache.
  • Quit smoking and reduce the consumption of alcohol. (10)
  • Exercise regularly – start walking daily in the morning for at least 20 minutes.
  • Have a well-balanced regular diet.
  • Drink plenty of water, fresh juice, and liquids to keep yourself well hydrated.
  • Reduce the consumption of caffeine and sugar products.

Take away message

Tension headache is a common type of headache that affects almost 80% of the population in the United States. It is typically characterized as tightness or contraction of the muscles around the forehead. Some of the common causes of a tension headache include excessive emotional and physical stress, skipping meals, dehydration, sinus infections, cold or flu, prolonged work on a computer screen, bad posture, and lack of sleep.


The symptoms include pain around the eyes, forehead, back of the head and neck. Moreover, in severe cases, the individual may feel nausea, vomiting, and sensitivity to lights and loud noise.

Treatment of tension headache is usually based on the underlying cause. In most cases, medication therapy with pain killers and muscle relaxants may ease the symptoms. However, stress management, balanced diet, improved water intake, and behavioral therapy are effective in managing tension headaches.


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