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Tension headaches

Tension headaches are what most people think of as a headache, and are the most common type of headache.

Around half of UK adults have tension headaches at least once or twice a month.

Tension headaches are known as primary headaches, which mean they are not caused by other medical conditions.

Most tension headaches clear up on their own and can be treated with over-the-counter painkillers, or by relaxing more.

Seek medical advice if headaches happen several times a week or become severe.

What causes tension headaches?

There is no single cause for tension headaches. This type of headache is not an inherited trait that runs in families. In some people, tension headaches are caused by tightened muscles in the back of the neck and scalp. This muscle tension may be caused by:

Tension headaches are usually triggered by some type of environmental or internal stress. The most common sources of stress include family, social relationships, friends, work and school. Examples of stressors include:

  • Having problems at home/difficult family life
  • Having a new child
  • Having no close friends
  • Returning to school or training - preparing for tests or exams
  • Going on holiday
  • Starting a new job
  • Losing a job
  • Being overweight
  • Deadlines at work
  • Competing in sports or other activities
  • Being a perfectionist
  • Not getting enough sleep
  • Being over-extended - involved in too many activities/organisations

Episodic tension headaches are usually triggered by an isolated stressful situation or a build-up of stress. Daily stress can lead to chronic (long-term) tension headaches.

What are the symptoms of tension headaches?

People with tension headaches commonly report these symptoms:

  • Mild to moderate pain or pressure affecting the front, top or sides of the head
  • Headache occurring later in the day
  • Difficulty falling asleep and staying asleep
  • Chronic fatigue
  • Irritability
  • Disturbed concentration
  • Mild sensitivity to light or noise
  • General muscle aching

A tension headache may appear periodically (episodic, less than 15 days per month) or daily (chronic, more than 15 days per month). Chronic tension headaches may vary in intensity throughout the day, but the pain is almost always present.

Unlike migraine headaches, there are no associated neurological symptoms - such as muscle weakness, or blurred vision - in people with tension headaches. In addition, severe sensitivity to light or noise, stomach pain, nausea and vomiting are not symptoms usually associated with tension headaches.

How are tension headaches treated?

The goals of treatment for tension headaches are to prevent further attacks and relieve any current pain. Treatment includes:

  • Taking the medications recommended by your doctor
  • Avoiding or minimising the causes or triggers
  • Stress management/relaxation training
  • Home treatments
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