A tension-type headache (TTH) is generally a mild to moderate pain that's often described as feeling like a tight band around the head. A tension-type headache is the most common type of headache, yet its causes aren't well understood.
Treatments for tension-type headaches are available. Managing a tension-type headache is often a balance between practicing healthy habits, finding effective nondrug treatments and using medications appropriately.
Signs and symptoms of a tension-type headache include:
Tension-type headaches are divided into two main categories — episodic and chronic.
Episodic tension-type headaches can last from 30 minutes to a week. Frequent episodic tension-type headaches occur less than 15 days a month for at least three months. Frequent episodic tension-type headaches may become chronic.
This type of tension-type headache lasts hours and may be continuous. If your headaches occur 15 or more days a month for at least three months, they're considered chronic.
Tension-type headaches can be difficult to distinguish from migraines. Plus, if you have frequent episodic tension-type headaches, you can also have migraines.
Unlike some forms of migraine, tension-type headaches usually aren't associated with visual disturbances, nausea or vomiting. Although physical activity typically aggravates migraine pain, it doesn't make tension-type headache pain worse. An increased sensitivity to either light or sound can occur with a tension-type headache, but this symptom isn't common.
If tension-type headaches disrupt your life or you need to take medication for your headaches more than twice a week, see your doctor.
Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different. Occasionally, headaches may indicate a serious medical condition, such as a brain tumor or rupture of a weakened blood vessel (aneurysm).
If you have any of these signs or symptoms, seek emergency care:
The cause of tension-type headaches is not known. Experts used to think tension-type headaches stemmed from muscle contractions in the face, neck and scalp, perhaps as a result of heightened emotions, tension or stress. But research suggests that muscle contraction isn't the cause.
The most common theory supports a heightened sensitivity to pain in people who have tension-type headaches. Increased muscle tenderness, a common symptom of tension-type headaches, may result from a sensitized pain system.
Stress is the most commonly reported trigger for tension-type headaches.
Because tension-type headaches are so common, their effect on job productivity and overall quality of life is considerable, particularly if they're chronic. The frequent pain may render you unable to attend activities. You might need to stay home from work, or if you do go to your job, your ability to function may be impaired.
In addition to regular exercise, techniques such as biofeedback training and relaxation therapy can help reduce stress.
Using medications in conjunction with stress management techniques may be more effective than either treatment alone in reducing your tension-type headaches.
Additionally, living a healthy lifestyle may help prevent headaches:
If you have chronic or recurrent headaches, your doctor may conduct physical and neurological exams, then try to pinpoint the type and cause of your headaches using these approaches:
Your doctor can learn a lot about your headaches from a description of your pain. Be sure to include these details:
If you have unusual or complicated headaches, your doctor may order tests to rule out serious causes of head pain, such as a tumor. Two common tests that can be used to image your brain include:
Some people with tension-type headaches don't seek medical attention and try to treat the pain on their own. Unfortunately, repeated use of pain relievers that are available without a prescription can actually cause another type of headache, medication overuse headache.
A variety of medications, both nonprescription and prescription, are available to reduce the pain of a headache, including:
Your doctor may prescribe medications to reduce the frequency and severity of attacks, especially if you have frequent or chronic headaches that aren't relieved by pain medication and other therapies.
Preventive medications may include:
Preventive medications may require several weeks or more to build up in your system before they take effect. So don't get frustrated if you haven't seen improvements shortly after you begin taking a drug.
Your doctor will monitor your treatment to see how the preventive medication is working. In the meantime, overuse of pain relievers for your headaches may interfere with the effects of the preventive drugs. Ask your doctor about how often to use pain relievers while you’re taking preventive medication.
Rest, ice packs or a long, hot shower may be all you need to relieve a tension-type headache. A variety of strategies can help you reduce the severity and frequency of chronic tension-type headaches without using medicine. Try some of the following:
The following nontraditional therapies may help if you have tension-type headache pain:
Living with chronic pain can be difficult. Chronic pain can make you anxious or depressed and affect your relationships, your productivity and the quality of your life.
Here are some suggestions: