Patient education: Tension headache (The Basics)

What is a tension headache? — 

This is the most common type of headache. It can feel like pressure or tightness on both sides of the head. This is also called a "tension-type headache."

Some people get tension headaches a lot. In this case, doctors might prescribe medicine or suggest other treatments to help prevent them.

What does a tension headache feel like? — 

A tension headache usually involves:

●Dull pain or pressure in the head – People sometimes describe the headache as feeling like a tight cap or band squeezing the head. It usually affects both sides of the head. The pain is steady, not throbbing, and does not get worse with simple movements like walking.

●Sore muscles – The muscles in the head, neck, and shoulders might feel sore or tight. Some people have muscle soreness even when they don't have a headache.

The headache can last from minutes to days.

Will I need tests? — 

Probably not. Your doctor should be able to tell if you have tension headaches by doing an exam and asking about your symptoms. If they think something else could be causing your headache, they might order tests.

How are tension headaches treated? — 

Most people can use non-prescription medicines to treat tension headaches, such as:

●"NSAID" medicines like ibuprofen (sample brand names: Advil, Motrin), naproxen (sample brand name: Aleve), or aspirin

●Acetaminophen (sample brand name: Tylenol)

●A medicine that combines acetaminophen, aspirin, and caffeine (sample brand name: Excedrin)

In the hospital or emergency department, doctors sometimes treat severe tension headaches with a medicine given as a shot or through an IV. (An IV is a thin tube that goes into a vein.)

If you get headaches often, work with your doctor to find a treatment that helps. Do not try to manage frequent headaches on your own with non-prescription pain medicines. Taking these too often can actually cause more headaches later.

What else can I do to feel better? — 

Some people feel better with rest, massage, or using heat or cold. There is not a lot of evidence these things work, but they might help in some cases.

Can tension headaches be prevented? — 

Sometimes. Some people find their headaches are triggered by certain things. If you can avoid some of these things, you can lower your chances of getting headaches.

Common tension headache triggers include:

●Stress or mental strain

●Not sleeping enough

●Dehydration

●Alcohol

●Sunlight exposure

To learn about your triggers, it helps to keep a "headache diary" (table 1). This involves writing down every time you have a headache and what you did before it started.

If your headaches are frequent or severe, your doctor can suggest other ways to help prevent them. These might include:

●"Biofeedback," which helps you learn to relax tight muscles

●Relaxation techniques

●Finding ways to manage stress

●Changing your sleep or exercise habits

●Working with a therapist to learn ways to cope with your headaches

●Medicines

What if I want to get pregnant? — 

Talk to your doctor or nurse before you start trying. Some medicines used to treat and prevent headaches are not safe during pregnancy, so you might need to switch medicines before you get pregnant.

When should I call the doctor? — 

Call your doctor or nurse if:

●Your headaches start feeling different or get worse.

●You get headaches on 15 or more days of each month.

●You have other symptoms with your headaches such as fever, weakness, confusion, or vision problems.

More on this topic

Patient education: Headaches in adults (The Basics)
Patient education: Headaches in children (The Basics)
Patient education: Medication overuse headache (The Basics)
Patient education: Cluster headache (The Basics)
Patient education: Keeping track of your headaches (The Basics)

Patient education: Headache causes and diagnosis in adults (Beyond the Basics)
Patient education: Headache treatment in adults (Beyond the Basics)
Patient education: Headache in children (Beyond the Basics)