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by EBSCO Medical Review Board
(Muscle Contraction Headache; Tension-Type Headache)

Definition

Tension headache is a spreading, steady head pain that can be mild or severe.

Tension Headache: Areas of Pain
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Causes

Tension headaches develop when muscles in the neck, face, and scalp contract.

The cause is not known. Genes are thought to play a role.

Risk Factors

This problem often starts in people who are 25 years of age and older. It is also more common in women.

Other things that may raise the risk are:

  • Stress
  • Mental tension
  • Being emotionally upset

Symptoms

Some tension headaches happen often. Others happen only once in a while. They do not often get in the way of daily activities. Tension headaches are:

  • Felt on both sides of the head
  • Have a pressing or tightening feeling

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. This is often enough to make the diagnosis.

Treatment

The goal is to manage symptoms and lower the risk of future headaches. Choices are:

Medications

Over-the-counter pain medicine, such as ibuprofen, is often enough to ease headaches.

A caffeine supplement with a pain reliever may also help. Antidepressants may be given for those with severe headaches. It can lower the risk of future headaches.

Other Management

Easing muscle tension can prevent future headaches. It can also ease headaches that have already started. Steps that may help include:

  • Find and stop causes of tension such as poor posture or movement that causes strain in neck and shoulders
  • Regular exercise to strengthen area and ease tension
  • Massage
  • Hot or cold packs—whichever works best
  • Physical therapy to address regular tension or pain problems in neck
  • Stress management and relaxation methods
  • Biofeedback to learn how to control muscle tension

Prevention

Managing stress and regular healthy movement may prevent headaches.

RESOURCES

American Headache Society  http://www.americanheadachesociety.org 

National Headache Foundation  http://www.headaches.org 

CANADIAN RESOURCES

Canadian Headache Society  https://headachesociety.ca 

Help for Headaches  http://www.headache-help.org 

References

Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.

Headache information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. Updated December 31, 2019. Accessed April 9, 2020.

Tension-type headache. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/tension-type-headache  . Updated February 8, 2017. Accessed April 9, 2020.

Tension-type headache. National Headache Foundation website. Available at: https://headaches.org/2007/10/25/tension-type-headache. Accessed April 9, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 02/2021
  • Update Date: 04/09/2021