Tension-type headache

A tension-type headache is an everyday headache due to stress,tiredness or noise. Painkillers or relaxation may help.

Information written and reviewed by Certified Doctors.

Contents

Key Information

What should I do?

If you think you have this condition there are some things you can do to make yourself feel better.

How is it diagnosed?

There isn’t a specific test to diagnose tension-type headaches. Your doctor can gather a lot about your headache from your description of the characteristics, intensity and location of the pain. They will probably examine you and check your blood pressure and your eyes. If your doctor suspects that you have an unusual or complicated headache, they might order additional tests to rule out serious causes. This often involves a scan of your head with MRI (magnetic resonance imaging) or CT (computerised tomography).

What is the treatment?

Treatment for tension-type headaches is largely to help manage the symptoms. Non-prescription painkillers can be effective, and you may find that regular exercise and relaxation can also help.

In order to identify any triggers, you may also wish to keep a diary of when you experience the headaches.

When to worry?

If you develop any of the following symptoms then you should see a doctor immediately:

  • sudden, severe headache
  • worst headache of your life
  • headache and neck stiffness
  • headache and vomiting
  • headache and fever
  • confusion, abnormal drowsiness or loss of consciousness
  • headache following a head injury
  • sudden weakness of the face, arm or leg
  • sudden changes in your vision
  • sudden changes to your speech.

Introduction

A tension-type headache is the most common type of headache and the one we think of as a normal, everyday headache.

It may feel like a constant ache that affects both sides of the head. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes.

A tension headache normally won't be severe enough to prevent you doing everyday activities.

It usually lasts for 30 minutes to several hours, but can last for several days.

Who gets tension headaches?

Most people are likely to have experienced a tension headache at some point. They can develop at any age, but are more common in teenagers and adults. Women tend to suffer from them more commonly than men.

It's estimated that about half the adults in the UK experience tension-type headaches once or twice a month, and about 1 in 3 get them up to 15 times a month.

About 2 or 3 in every 100 adults experience tension-type headaches more than 15 times a month for at least three months in a row. This is known as having chronic tension-type headaches.

When to seek medical help

There's usually no need to see your doctor if you only get occasional headaches. However, see your doctor if you get headaches several times a week or your headaches are severe.

Your doctor will ask questions about your headaches, family history, diet and lifestyle to help diagnose the type of headache you have.

You should seek immediate medical advice for headaches that:

  • come on suddenly and are unlike anything you've had before
  • are accompanied by a very stiff neck, fever, nausea, vomiting and confusion
  • follow an accident, especially if it involved a blow to your head
  • are accompanied by weakness, numbness, slurred speech or confusion

These symptoms suggest there could be a more serious problem, which may require further investigation and emergency treatment.

What causes tension headaches?

The exact cause of tension-type headaches isn't clear, but certain things have been known to trigger them, including:

  • stress and anxiety
  • squinting
  • poor posture
  • tiredness
  • dehydration
  • missing meals
  • lack of physical activity
  • bright sunlight
  • noise
  • certain smells

Tension-type headaches are known as primary headaches, which means they're not caused by an underlying condition. Other primary headaches include cluster headaches and migraines .

How are tension headaches treated?

Tension-type headaches aren't life-threatening and are usually relieved by painkillers or lifestyle changes.

Lifestyle changes

Relaxation techniques can often help with stress-related headaches. This may include:

  • yoga
  • massage
  • exercise
  • applying a hot flannel to your forehead and neck

Read more about relaxation tips to help with stress .

Painkillers

Painkillers such as paracetamol or ibuprofen can be used to help relieve pain. Aspirin may also sometimes be recommended.

If you're taking these medications, you should always follow the instructions on the packet. Pregnant women shouldn't take ibuprofen during the third trimester, as it could risk harming the baby, and children under 16 shouldn't be given aspirin.

Medication shouldn't be taken for more than a few days at a time and medication containing codeine, such as co-codamol, should be avoided unless recommended by a doctor.

Painkiller headaches

Taking painkillers over a long period (usually 10 days or more) may lead to medication-overuse headaches developing. Your body can get used to the medication and a headache can develop if you stop taking them.

If your doctor suspects your headache is caused by the persistent use of medication, they may ask you to stop taking it. However, you shouldn't stop taking your medication without first consulting your doctor.

Read more about painkiller headaches.

Preventing tension headaches

If you experience frequent tension-type headaches, you may wish to keep a diary to try to identify what could be triggering them. It may then be possible to alter your diet or lifestyle to prevent them occurring as often.

Regular exercise and relaxation are also important measures to help reduce stress and tension that may be causing headaches. Maintaining good posture and ensuring you're well rested and hydrated can also help.

Guidelines from the National Institute for Health and Care Excellence (NICE) states that a course of up to 10 sessions of acupuncture over a 5-8 week period may be beneficial in preventing chronic tension-type headaches.

In some cases, an antidepressant medication called amitriptyline may be prescribed to help prevent chronic tension-type headaches, although there's limited evidence of its effectiveness. This medication doesn't treat a headache instantly, but must be taken daily for several months until the headaches lessen.

Content supplied by NHS Choices