Use the form below to search the Health Library.

  
 Health Information  Health Articles  Any
http://search.ebscohost.com/login.aspx?direct=true&db=hlt&AN=2010812232&site=ehost-live

Tension Headache

(Muscle Contraction Headache; Tension-Type Headache)
  • Definition

    Tension headache refers to radiating, steady pain in the head, neck, or eyes that can be mild or intense. Tension headaches may be occasional or chronic.
    Tension Headache: Areas of Pain
    IMAGE
    Copyright © Nucleus Medical Media, Inc.
  • Causes

    Tension headaches may occur when muscles in the neck, face, and scalp contract. In some cases, muscle contraction is the result of teeth grinding and jaw clenching. In others, it may be unknown.
  • Risk Factors

    Tension headaches are more common in women. Other factors that may increase your chance of getting a tension headache include:
  • Symptoms

    Some tension headaches are nearly constant, with daily pain that may vary in intensity, while others occur once in a while. Symptoms usually start slowly and build.
    Tension headache may cause:
    • Constant, steady pain and pressure
    • Dull and achy pain
    • Pain which may be felt on both sides of the head, in the forehead, temples, and the back of the head
    • Pressure may feel like a tight band around the head
    • Intensity ranges from mild to severe and can vary during the day
    • Tightness in head and neck muscles
    Headaches can become so severe and constant that they interfere with normal activities and sleep.
  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis can be made on exam, based on specific features. The cause of the headaches however, may be more difficult to determine.
    Tests may include:
    • Neurological exam
    • Imaging is not usually needed, but if pain is unusual or severe it may be done to look for other causes of the headache. Imaging tests include:
  • Treatment

    There are no specific cures for tension headaches, but they can be managed. Therapies aim to stop the headache and reduce the frequency of future episodes.
    Treatment may include:
    Medications
    For occasional headaches, your doctor may recommend:
    • Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain
    • Prescription pain relievers
    Note: Pain medications are most effective when taken at the first sign of pain and before it becomes severe. Overusing some over-the-counter medications may actually cause headaches. Continuous use of medications may create rebound pain when you stop taking the drug.
    For chronic headaches, your doctor may recommend the following to treat or prevent headaches:
    • Antidepressants
    • Muscle relaxers
    • Botulinum toxin injections (Botox)
    • Anti-seizure medication
    • Beta blocker medication
    Self-care During the Headache
    Self-care may include:
    • Rest if needed
    • An ice pack or heat pack on your head or neck to ease discomfort
    • A warm shower, with water running over tense muscles
    Lifestyle Changes
    Lifestyle changes may include:
    • Regular exercise
    • Improving your posture
    • Adequate sleep
    • Regular breaks from tasks
    • Stress management and relaxation techniques
    • Counseling to:
      • Develop new coping skills
      • Identify events that trigger the headaches and work toward resolution
    Additional Therapies
    Additional therapies may include:
    • Acupuncture—to have more headache-free days and lessen the intensity of headaches when they do occur
    • Physical therapy—to develop a home exercise program.
    • Massage therapy
  • Prevention

    To help reduce your chances of getting a tension headache, try the following strategies:
    • Keep a diary, marking when headaches occur and what you were doing before they started.
    • Learn to recognize what provokes a tension headache.
    • Avoid or minimize stressful situations.
    • Take frequent breaks to walk or move around.
    • Make time for pleasurable activities.
    • Practice relaxation techniques, such as deep breathing and focusing on something pleasant.
    • Learn techniques for coping with difficult or stressful situations.
    • Make time for friends and build a strong support system.
    • Go to bed early and get a good night's sleep.
    • Exercise regularly.
    • Do not slouch.
    • Hold the phone, rather than cradling it on your shoulder, or use a headset.
  • RESOURCES

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

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

    CANADIAN RESOURCES

    Headache Network Canada http://www.headachenetwork.ca

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

    References

    Dambro MR. Griffith's 5-Minute Clinical Consult. Philadelphia, PA: Lippincott Williams & Wilkins; 1999.

    Goetz CG. Textbook of Clinical Neurology. Philadelphia, PA: WB Saunders Co; 1999.

    Melchart D, Streng A, Hoppe A, et al. Acupuncture in patients with tension-type headache: randomized controlled trial. Brit Med J. 2005;331:376-379.

    NINDS headache information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/headache/headache.htm. Updated November 8, 2013. Accessed December 30, 2013..

    Rakel RE, Bope ET. Conn's Current Therapy 2001. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.

    Tension headache. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 19, 2013. Accessed December 30, 2013.

    Tension-type headache. National Headache Foundation website. Available at: http://www.headaches.org/education/Headache%5FTopic%5FSheets/Tension-Type%5FHeadache. Accessed December 30, 2013.

    12/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Jena S, Witt CM, Brinkhaus B, Wegscheider K, Willich SN. Acupuncture in patients with headache. Cephalalgia. 2008;28:969-979.

    8/27/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Robberstad L, Dyb G, Hagen K, Stovner LJ, Holmen TL, Zwart JA. An unfavorable lifestyle and recurrent headaches among adolescents: The HUNT Study. Neurology. 2010;75(8):712-717.

    5/12/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Yancey JR, Sheridan R, et al. Chronic daily headache: diagnosis and management. Am Fam Physician. 2014 Apr 15;89(8):642-8.

    Revision Information

  • Connect with Steward

    Visit Our Twitter Feed Visit Our Facebook Page Email This Page Print This Page

    Subscribe to our patient e-newsletter

    Copyright © 2014 Steward Health Care
    Connect Healthcare Panacea CMS Solutions