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Tension headaches are the most common type of headache. They cause dull, aching pain on both sides of your head. In addition to mild or moderate pain and pressure in your head, you might also feel tightness in the muscles in your head or neck.
At UPMC, our headache experts offer a full range of treatments for tension headaches. After diagnosing your condition, our specialists will develop a comprehensive treatment plan to manage your headache pain — improving your quality of life so you can focus on work, school, and other everyday activities.
Tension headaches are the most common type of headache. They cause dull, aching pain on both sides of your head. In addition to mild or moderate pain and pressure in your head, you might also feel tightness in the muscles in your head or neck.
There are two types of tension headaches:
Doctors don't know what causes tension headaches. There is no link to hormones or genes passed down to kids from parents.
With a tension headache, you tighten the muscles in your jaw, face, scalp, and neck, which can cause pain. Some experts believe people with tension headaches may be more pain-sensitive or have tighter, more tender muscles.
Some people think tension headaches are only caused by stress. However, stress is one of many things that can trigger a tension headache. Tension-type headaches are also common in people with sleep problems.
Other triggers or conditions that increase your risk of tension headaches include:
Tension headaches are not dangerous. However, they can cause pain that impacts your quality of life and ability to carry out daily activities. If you leave your tension headaches undiagnosed, you could:
Your doctor may talk to you about making lifestyle changes to reduce your risk of tension headaches. Recommended lifestyle changes may include:
Your doctor may also suggest supplements to reduce your risk of tension headaches, such as:
Tension headaches are very common, with most people experiencing tension headaches at some point in their lives. They can happen at any age but are most common in older teens and adults. They are slightly more common in women than in men.
Some people describe tension headaches as mild-to-moderate "vise-like" pain, similar to a belt squeezing your head. However, the pain may differ based on how often you get tension headaches and the severity of your symptoms.
Tension headache pain may start several hours after you wake up and get worse throughout the day. It usually does not wake you up from sleeping.
In addition to pain, tension headaches may also cause:
Unlike migraines, tension headaches do not cause nausea, vomiting, or changes in vision or smell.
Tension headaches can last anywhere from 30 minutes to a few days.
Some people with migraines may think they have tension headaches. Talk to a headache doctor if you take pain medicine and feel no relief, your headaches happen frequently and are severe, or if you think you may have migraine symptoms.
If you have already been diagnosed with tension headache, you should contact your doctor if:
Sometimes, a more serious condition, such as a stroke or another brain disorder, can be mistaken for tension headaches. You should dial 911 if:
Your doctor will review your health history, ask about your symptoms, and do a physical exam.
When you arrive at your appointment, your doctor will:
There are no tests doctors can use to diagnose tension headaches. You may need imaging scans like a CT or MRI to rule out other causes of your headaches.
With treatment, most people can manage tension headaches and reduce their impact on quality of life.
The goal of tension headache treatment is to reduce the pain, improve your quality of life, and prevent future headaches.
You may need a combination of treatments to manage your tension headaches, including:
Things you can do to prevent or ease a tension headache include:
OTC pain relievers can help with tension headaches if your pain isn't severe. Taking them with added caffeine can boost the effects — unless caffeine is a headache trigger for you.
OTC analgesics or non-steroidal anti-inflammatory drugs (NSAIDs) include:
The side effects of these drugs include stomach, kidney, and bleeding problems. You should check with your doctor before taking these OTC pain relievers to make sure they are safe for you.
Don't use OTC pain relievers more than twice a week. Using these drugs too often may cause a medicine overuse headache when the drugs stop working. This means your headaches will get worse and happen more often.
If your headache is chronic and pain relievers don't help, your headache may be a migraine. Talk to your doctor about migraine medicine.
Trigger point shots can treat cluster headaches, migraines, and tension headaches. They reduce muscle pain in your neck and shoulders.
When you get the shots, your doctor will:
Your doctor may prescribe antidepressant medicine to prevent chronic tension headaches. These drugs have analgesic actions that relieve pain even if you're not depressed.
Serotonin, the brain chemical impacted by antidepressants, controls the circuits sending pain messages. Increasing serotonin levels can prevent tension headaches.
A common prescription is the tricyclic antidepressant amitriptyline. Side effects are sleepiness, weight gain, and constipation.
When you choose UPMC for tension headache care, you will receive:
By UPMC Editorial Staff. Last reviewed on 2025-02-25.
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