TENSION HEADACHE

Medically Verified By: Dr. Sachin Shelke

Types
Symptoms
Causes And Risk Factors
Prevention
Diagnosis
Treatment
Lifestyle/management
Prognosis And Complications
Alternative Treatments
References

All
News
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A tension headache, commonly known as stress headache, is characterized as a mild to moderate headache that feels similar to a tight band around your head. It is one of the most common type of headache whose exact causes has not yet been determined. Usually brought about when someone is stressed or tense, this headache usually radiates from the nape of the neck to the front of the head. While this sensation and its intensity can vary from one person to the next, the pain can be quite debilitating, causing sensitivity to light and fatigue in certain people.

Types

A tension headache is broadly classified into two categories depending on its frequency and severity:

Episodic – It appears frequently or periodically, which indicates that you might suffer from this headache for 15 days a month. The pain is often mild to moderate in nature and usually causes pressure on the forehead or back of the neck. Episodic tension-type headaches are classified into frequent and infrequent tension-type headaches.

Chronic – If you experience headache more frequently, i.e. more than 15 days in a month, you are likely to be suffering from chronic or daily tension headache. It results in excruciating pain in the front and sides of the head. Although the intensity of the pain may vary, it is present all through the day.

Based on frequency with which tension-type headaches occur, they are classified as follows:

Infrequent episodic tension-type headache, which occurs <12 days in a year

Frequent episodic tension-type headache, which occurs between 12 and 180 days in a year. They will have >10 episodes within three months.

Chronic tension-type headache - They occur >180 days in a year, i.e. they occur >15 days a month for at least three months.

Symptoms

The common signs and symptoms of tension headache are listed below:

Infrequent episodes of headache lasting minutes to days.

The pain is typically bilateral, pressing or tightening in quality and of mild to moderate intensity, but does not worsen with physical activity.

Although you might not experience nausea, you might suffer from bouts of photophobia (sensitivity to light) or phonophobia (sensitivity to loud noise).

Causes And Risk Factors

Causes

Although the exact cause of tension headaches is not clear, they are generally caused when your neck and scalp muscles become tense because of excessive straining or holding your head in one position for a long time. Other factors that might lead to muscle contractions include a head injury, stress, anxiety or depression.

Risk Factors

According to the American Chiropractic Association, a person suffering from a tension headache should avoid teeth clenching. According to them, when upper teeth touch the lower teeth, it results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull. This leads to TMJ irritation and leads to a form of tension headache. Moreover, here are certain common day-today activities that trigger a tension headache:

Sleeping in a cold room or in an abnormal position

Excessive smoking or alcohol consumption (Here are side-effects of alcohol you need to know)

Drinking too much of caffeinated beverages (withdrawal from caffeine)

Cold and sinus infection

Skipping meals

Eye strain

Fatigue

Bright sunlight

Women are at more risk than men

Hormonal changes during a woman’s menstrual period or during menopause can risk her to more headaches

Stress

Chronic overwork

Sleeping excessively or too less

Prevention

You can avoid the occurrence of tension headaches by following a few simple practices. These are listed below:

Ensure that you do not stare for too long at the computer screen at work. Here are four easy tips to prevent eye strain and computer vision.

Remain hydrated by drinking a lot of water during the day

Get a good 6-7 h sleep at night to avoid such headaches

Eat a healthy and nutrient-rich diet (that too on-time)

Avoid smoking, drinking and caffeinated beverages

Stay away from triggers that might cause tension headaches

Practice stress reduction methods

Practice good posture by standing and sitting straight

Treat health problems such as depression and anxiety

Try making use of a headache diary. This helps your doctor identify the cause of your headache and accordingly plan your treatment. This diary will record what time you get your headache, the date, and the activity you were performing when the headache occurred.

Diagnosis

As such there are no tests to identify a tension headache. However, your doctor will review your personal and family medical history, study your symptoms and conduct an examination. Your doctor may rule out other underlying medical causes for your headache to plan your treatment. This is essential especially if you have a headache that is new or different or increasing in intensity and frequency. Your doctor may perform a neurological examination and examine your eyes, sinuses, head, and neck. Your doctor may ask you a few questions to test your short-term memory. In certain cases, if you present with unusual symptoms, your doctor may recommend a CT scan, an X-ray of your neck or sinuses, and an EEG(Electroencephalogram) to rule out seizures.

Treatment

The primary aim of treatment of tension headaches is to relieve pain and symptoms and prevent further attacks. It includes lifestyle changes, medications and stress management.

Lifestyle modifications: You can relieve symptoms of headache by making changes to your daily routine such as avoid intake of caffeine, eating a balanced diet, being physically active and staying away from factors that cause a tension headache.

Medications: Painkillers such as paracetamol, aspirin, acetaminophen, and ibuprofen aid in relieving pain. However, you should consult your doctor before taking them to prevent various side-effects of these drugs when used in excess. Furthermore, antidepressants and muscle relaxants are prescribed in some cases to combat symptoms associated with a tension headache.

Stress management: Meditation, yoga and acupressure are some of the effective measures to treat tension headaches. As being stressed out increases your risk of this condition, you are advised to stay away from stress.

Home Remedies

Here are certain quick and simple ways you can use to thwart the pain associated with a tension headache.

Rest your eyes: Close your eyes while sitting comfortably on a chair, rub both your palms together such that they become warm and then place them over your eyes such that your fingers overlap. Breathe in deep and ensure your back is straight.

Light pressure: Close your eyes and cup them with the palm of your hands. Apply pressure for ~2-3 min and release. This point helps in relaxation and calms the mind.

Peppermint teabags: Wet the tea bags, cool them for a little while and place them on your eyes for ~5 min.

Ginger Tea: Steep some crushed ginger (a one-inch-long piece should suffice) in a cup of water and sip on this tea before bed for relief.

Chamomile tea: Brew a cup of chamomile tea (ensure the tea bag is soaked in water for around ten minutes before you drink it) and add some honey to sweeten it. This might surely help in providing instant relief.

Lavender or peppermint oil bath: Footbaths or oil baths play an important role in relieving tension headaches. You can either immerse your feet in warm water containing lavender or peppermint oil or add a few drops of these oils to water while bathing.

Lifestyle/management

Certain lifestyle changes such as maintaining a tension headache diary can help identify the triggering factors for your headache. This can then be worked upon by modifying your environment and changing certain habits that may trigger a tension headache episode. A tension headache diary identifies the date, time of your headache, what physical activities you were doing when the headache occurred, how well you slept the previous night, and whether there were any stressors present, which triggered the episode. You will be able to identify what treatment worked for you, which helped relieve your headache. Moreover, inculcating certain good habits like getting enough sleep, eating a healthy diet, getting regular exercise, quitting smoking and using relaxation techniques can help reduce stress and tension headaches. Certain foods that can trigger a tension headache and that should be avoided are as follows.

Cheese

Chocolates

Flavour enhancers such as monosodium glutamate (MSG), usually found in Chinese food

Peanut butter

Nuts

Onions

Dairy products

Pickled or fermented foods

Caffeine containing drinks and food

Certain foods such as red wine, smoked fish, figs, chicken liver, and some beans

Banana and citrus fruits

Nitrate containing meats such as hot dogs, cured meats, salami, and bacon

If you are able to identify which food causes your headache, you can eliminate that item from your diet, known as an elimination diet. You can reintroduce them at a later date to correctly identify what food triggered your headache.

Prognosis And Complications

Prognosis

Though tension headaches are bothersome, they may disrupt your career or personal life in certain cases. For minor symptoms, avoiding the trigger can be beneficial. In addition to medication, certain therapies can help you overcome your symptoms with negligible disruptions to your life.

Complications

Medication overuse and addiction or dependence on narcotic pain killers are a common complication seen in individuals with severe tension headaches.

Alternative Treatments

Various alternative treatments have been employed to relieve tension headaches. They are listed below.

Herbs - Herbs such as peppermint oil and tiger balm have been reported to be effective in relieving tension headaches when applied on the forehead.

Acupuncture involves the insertion of fine needles into various parts of your body depending on the site of pain has been proven to prevent tension headaches.

Chiropractice - Tension headaches caused by pain in the neck can be relieved with the help of a chiropractitioner. This involves spinal manipulation to treat neck pain and in turn relieve the headache.

Massage and physical therapy - If you have chronic tension headaches, regular massages can help relieve it. A physical therapist can teach you correct posture and certain stretches for your head and neck, which can be beneficial to relieve your headache.

Certain areas on your hands and feet are believed to control all areas on your body. These points on your hands and feet are called “reflex points.” Reflexology, which involves placing pressure on these “reflex points” relieves headache, improves your energy levels and your general well-being.

Homeopathy - Certain homeopathic medications have been reported to be effective in relieving chronic headaches. Your homeopath will consider your physical, intellectual, and emotional constitution before deciding which medication is best suited for you.

Mind body medicine - Certain relaxation techniques that combine your mind and body have been proven effective in relieving tension headaches. Biofeedback, which involves controlling your body functions and receiving feedback by achieving relaxation of your muscles, helps in relieving your pain and headache. Other relaxation exercises such as deep breathing, yoga, meditation, hypnotherapy, and guided imagery have been reported to be effective in relieving stress and reducing your headache.