The Vice Grip Of Tension Headaches
Tension headaches are the most common type of headache. The steady, dull pain is often felt in the forehead, temples or back of the neck. Tension headaches often feel like a tight band is encircling the head.
Most tension headaches are over after an hour or two, but they can last for days. They are usually not linked with other symptoms, and there is no pre-headache syndrome as is often seen in migraine headaches. Stress and emotions like depression or anxiety can trigger tension headaches. You may have more tension headaches during a stressful period in your life, only to find them go away when life is back to an even keel.
What causes tension headache?
The exact cause is not known. Muscle tension in the head and neck is often related to the headache, but is not the primary cause. Rather, the current theory is that changes in levels of chemicals in the brain, such as endorphins and serotonin, somehow modify pain pathways.
How is tension headache diagnosed?
Your doctor will ask you about your symptoms and do a physical exam. That’s usually enough to diagnose tension headache. Be prepared to give a detailed description of your pain, where it hurts and if you have other symptoms, even if they seem unrelated. Talk about any stressful situations that bring on the headaches or life events that may be going on. If you have unusual symptoms, your doctor may order brain imaging tests, such as a head CT or MRI.
How do I know my headache is more serious?
Most headaches are not serious. But some headaches are “secondary,” due to another medical condition. Rarely, these headaches may be the result of bleeding, stroke, brain tumor or infection.
CALL 9-1-1 if you have a sudden severe headache, or a sudden headache with any neurologic signs, including:
Visual problems Passing out, or nearly passing out Numbness or weakness Trouble speaking or understanding speech Confusion Trouble walking or with balance
Get emergency medical help if you have a severe headache with a high fever, rash, neck stiffness or pain. Also seek immediate medical care for a headache that gets worse or does not get better with treatment.
Other warning signs include new headaches in persons age 50 or older, or those who have a history of HIV/AIDS or cancer. Let your doctor know if you have a change in your regular headache pattern.
Treating tension headaches
Most tension headaches end within an hour or two and usually get better quicker with over-the-counter pain relievers like acetaminophen or NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen or naproxen.
Check with your doctor first to be sure that these medications are right for you. Follow the instructions on the label. If your headaches become chronic and you are using these medicines on a regular basis, see your doctor. Regular use can raise your risk of stomach ulcers, bleeding or other problems. If you use these medications three times or more a week, they can actually cause you to have more frequent headaches.
If your headaches persist, your doctor may prescribe medications, including:
Stronger NSAIDs or combination medications to treat the headache Antidepressants, which can help prevent headaches.
Other things you can do on your own
Emotional upset, stressful periods and major life changes are often unavoidable.
Try meditation, yoga and other relaxation techniques to reduce stress. You can learn to do these yourself. Try massage therapy to help relieve tension and loosen tight muscles. Apply a warm compress to your neck and shoulders or take a warm shower.
Silberstein SD,Young WB. Tension type headache. In: Goetz CG. Goetz: Textbook of Clinical Neurology, 3rd ed. Philadelphia, PA: Saunders Elsevier; 2007 American Headache Society. Types of headaches. Accessed: 09/02/2009 National Headache Foundation. Tension-type headache. Accessed: 09/02/2009 Cutrer FM, Moskowitz MA. Headaches and other head pain. In: Goldman L, Aussielo D, eds. Goldman: Cecil Medicine, 23rd ed. Philadelphia, PA: Saunders Elsevier; 2007. Gallagher RM. Headache. In: Rakel RE, Bope ET, eds. Rakel: Conn’s Current Therapy 2008, 60th ed. Philadelphia, PA: Saunders-Elsevier; 2008.