Tension type headache

What Does a Tension-Type Headache Feel Like?

Tension-type headaches, the official name for tension or stress headaches, are a non-throbbing, pressure pain in part or all of the head, and may be associated with neck pain or tightness  A tension headache is often described as a “tight band” around the head, or feeling like the head is “in a vise”.  A stress headache or tension-type headache is usually not associated with nausea, or with avoidance of light or sound.  It is not made worse by routine physical activity, and is of mild or moderate pain intensity.

Tension-type headache is the most commonly occurring headache type of headache worldwide.  Tension-type headaches used to be called muscle contraction headaches, but not everyone who gets these headaches has tight muscles or has sore muscles in the scalp when they are touched or pressed.

Tension-type headache is usually what is called episodic, meaning that is comes and goes.  In most cases, it occurs occasionally, although it can be more frequent.  Rarely, tension-type headache occurs as a chronic headache, affecting you more days than not.  Tension-type headache is the most commonly-occurring headache worldwide, affecting up to 70% of some populations.

Are Tension Headaches Due to Stress?

While stress can increase the frequency of this headache type, just like it can increase the frequency of migraines, it is not felt to the cause of this type of headache.  Stress management can help with management of tension-type headaches; it also helps with the management of migraine.

The majority of people with tension-type headaches have episodic headaches, which means that you have less than 15 days of headache a month.  This can often be managed with over-the-counter medication or non-medication strategies such as massage.  (The International Headache Society makes a distinction between “infrequent” tension-type headaches at less than ten headaches a month, and “frequent” tension-type headaches, between 10 and 15 days a month.)  Chronic tension-type headaches, defined as more than 15 headache days a month, is more likely to require medical attention.

Natural Remedies for Tension Headaches

The natural remedies used most frequently for tension-type headaches are massage therapy, acupuncture, chiropractic treatment, aromatherapy, and biofeedback.

Causes of Headache

 

Types and Causes of Headaches

Headache is divided into two basic types:  primary and secondary.

Secondary headaches are those that are due to some underlying cause, like a sinus or brain injection, head or neck injury, or a brain tumor.  Most headaches that occur are not due to any kind of secondary cause, and are what we call primary headaches.  Less than 5% of all headaches are secondary headaches.  Although infrequent, there are over a hundred types of secondary headache, which is why there are expert headache doctors.

Primary headaches are those that do not have any sort of underlying cause.  The most commonly occurring primary headache is tension-type headache.  Migraine, also a primary headache, affects about 6% of men in the population, and 18-20% of women, depending on what country you live in.  Cluster headache, a primary headache in the group of headaches known as the trigeminal autonomic cephalgias, is far less common.  So what causes migraine?  In most cases, they are thought to be genetic.  Triggers set off a migraine attack, but are not the cause of the underlying migraine disorder.  The biochemical and physiologic basis of migraine is called pathophysiology, and is quite complex.  We are still figuring out all the things that occur in the brain when a migraine happens. 

by Christina Peterson, M.D.

updated Feb 8, 2020

Types of headaches described and explained

Different types of headaches

No two people feel or describe pain in exactly the same way.  However, the various types of headaches have symptoms that are fairly consistent.  The descriptions in this category are provided to help you determine what sort of headache you experience.  This is not a substitute for a diagnosis by a doctor, but is meant to provide a general guide.  Read more to see if you have potentially dangerous headaches.

This is also not an exhaustive list of all headache types, but gives an overview of those most commonly encountered.  For those who would like more information about the classification and diagnosis of various headaches, more information can be found in the International Headache Society’s ICDH-3 (International Classification of Headache Disorders, 3rd Edition). 

 

updated Feb 9, 2019

More on Medication Overuse Headache

Medication overuse headache occurs when the underlying headache disorder becomes worse because of the frequency of pain medication taken for the headache. Medication overuse headache, or MOH, occurs most frequently in migraine and posttraumatic headache. This problem has recently received attention in the news, triggered by the release of new guidelines for the treatment of headache in the UK by The National Institute for Clinical Excellence.

 

Learn more about medication overuse headache at these links:

Painkillers ‘are the cause’ of millions of headaches

Painkillers ’cause’ of millions of headaches (video)

Painkillers “can cause’ headaches

Diagnosing Medication Overuse Headache

Resource for Medication Overuse Headache

 

Another concern recently reported regarding the regular use of pain relief medications is discussed here:

Popular Pain Relievers Linked to Hearing Loss

 

Whether you are concerned about medication overuse headache, hearing loss, or any other consequence of frequent use of pain medications, reducing their use becomes important. The best way to do this is to prevent headaches such as by controlling migraine triggers, or by using a preventive medication.

 

Trigeminal Autonomic Cephalgias

What Are Trigeminal Autonomic Cephalgias?

 

The various autonomic cephalgias differ in definition by the duration and frequency of the headache attacks, as well as by some of the symptoms. Most of them respond to a medication called indomethacin.

The main types of trigeminal autonomic cephalgias are cluster headache, paroxysmal headache, and SUNCT, an acronym for Short-lasting, Unilateral, Neuralgiform headache attacks with Conjunctival injection and Tearing.

Details of the TACs can be found at ichd-3.org.

Cluster headache

Cluster Headache

Cluster headache involves severe pain which is one-sided, occurring in the eye or orbital region, or in the temporal region of the head. The pain is associated with redness of the eye, tears, nasal stuffiness, facial sweating, pupil constriction, a droopy eyelid (called ptosis), and often with a sense of restlessness. The headache pain occurs anywhere from once every other day to 8 times a day, and lasts 15 minutes to 3 hours.

Pain appears in regularly occurring episodes one or more times a day for several weeks, then symptoms disappear between “clusters.” Cluster attacks may not recur for months or years. In some cluster headache sufferers, there is a seasonal pattern to their occurrence, with attacks occurring in spring and fall, or in winter and summer.

Although cluster headaches are fairly well-known, they are actually not that common. Cluster headache affects less than 1% of the general population.

Cluster headache was once far more prevalent in men, with an 8:1 male:female predominance. More recently, that ratio has dropped. At present, the ratio has dropped to a 2.1:1 male:female predominance. The reason for this change is not clear, but may reflect changes in women’s lifestyles.

Cluster headache can be severe, and has been called the “suicide headache.”

A recent study has found a correlation between cluster headache and exposure to passive smoke in childhood.

by Christina Peterson, MD

updated April 12, 2016