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If you feel a dull, aching pressure headache, you may have a tension headache. This is the most common type of headache.
Tension headache symptoms often include pain on both sides of the head or tight muscles behind your head or neck. Most are mild to moderate in severity.
You may have a few or many tension headaches each month. See a headache doctor if they get worse or occur more often.
The UPMC Headache Center doctors tailor advanced treatments to your symptoms.
Our neurologists are experts in the subspecialty of headache medicine. They can help you live pain-free.
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Tension headaches are the most common headache, felt each year by about 38% of people.
The pain is often not severe, and you can be active through them.
Tension headaches affect women slightly more than men.
They can start in your teens and reach a peak in mid-adulthood. Some last into the elderly years.
There are two main types of tension headaches:
Both types cause dull pain on both sides of the head that doesn't pulsate or throb.
Symptoms may include pain in the forehead, temples, or behind your head and neck.
Doctors don't know what causes tension headaches. They do know there's no link to hormones or genes passed down to kids from parents.
Some experts believe people with tension headaches may be more pain-sensitive or have tender muscles.
With a tension headache, you tighten the muscles in your jaw, face, scalp, and neck, which can cause pain.
Some people think a tension headache is a stress headache. But 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 risks of tension headaches include:
If you leave your headaches undiagnosed, you could:
The doctors at UPMC are headache experts and can give you ways to live pain-free.
Taking a holistic approach, your doctor may talk to you about making some lifestyle changes.
To help prevent tension headaches, you should:
Your doctor may also suggest supplements to prevent tension headaches, such as:
Some people describe tension headaches as a "vise-like" pain or belt squeezing your head. They differ in how often you get them and how severe your symptoms are.
Emotions like anger, anxiety, stress, or exhaustion trigger episodic headaches.
The pain:
Chronic tension headaches feel like constant pressure on your face or forehead.
Some people get a runny nose and sinus pressure with a tension headache. They don't cause nausea and vomiting or changes in vision or smell, like with a migraine.
Sometimes people with migraines think they have tension headaches. Talk to a headache doctor if you take pain medicine and feel no relief.
There's no test for tension headaches.
Your doctor will ask you about your symptoms and health history and do a physical exam.
You may need a CT or MRI to see if other health problems are causing your headaches.
Your doctor may say "tension-type headache" since that's the medical term.
Things you can do to prevent or ease a tension headache include:
OTC pain relievers can help 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. Don't use OTC pain relievers more than twice a week.
Using these drugs too often risks causing 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.
Sometimes doctors use trigger point shots for tension headaches.
They can inject numbing medicine into a knot or sore spot in your neck or shoulder.
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.
