Tension-type headaches 

Introduction 

Headaches

Dr Anne MacGregor describes common causes of headaches, the differences between a normal headache and more severe forms such as a migraine, and treatment options.

Media last reviewed: 02/10/2013

Next review due: 02/10/2015

Medication-overuse headaches

A few people who have frequent tension-type headaches go on to develop a type of headache called a medication-overuse headache.

This type of headache can be caused by taking painkillers over a long period (usually 10 days or more). In these cases, your body may get used to the medication and a headache can develop if you stop taking them.

If your GP suspects your headache is caused by the persistent use of medication, they may ask you to stop taking the medication. However, you should not stop taking your medication without first consulting your GP.

Read more about painkiller headaches.

10 headache triggers

10 surprising headache triggers plus practical advice on how to avoid them

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, though 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. They are also more common in women than men.

It is 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 is usually no need to see your GP if you only get occasional headaches. However, you should see your GP if you get headaches several times a week or your headaches are severe.

Your GP 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 have 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 is not 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 are 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 changes in lifestyle.

Relaxation techniques such as yoga, massage, exercise or applying a hot flannel to your forehead and neck can help with stress-related headaches.

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

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

Medication should not be taken for more than a few days at a time or it can cause medication-overuse headaches and medication containing codeine, such as co-codamol, should be avoided unless recommended by a GP.

Preventing tension headaches

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

Regular exercise and relaxation are also both important to reduce stress and tension that may be causing headaches. Maintaining good posture and ensuring you are 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 is only limited evidence of its effectiveness. This medication does not treat a headache instantly, but must be taken daily for several months until the headaches lessen.

Page last reviewed: 27/08/2013

Next review due: 27/08/2015

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The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

User837252 said on 21 January 2014

Hi
I'm a 33 year old female and in the past 13 years since becoming pregnant with my first daughter have had headaches every single day. I have been for every test going and tried every known remedy to try and cure my headaches but no relief and no medical reason for why I'm getting these headaches. I have done a lot of research and come to the conclusion these are chronic tension headaches, the only way I can describe them is they start at the back of my neck and feel like someone pulled a tight hood over my head my vision blurs, I can't think straight and my voice even slurs when I talk, I feel so low due to the headaches otherwise life's perfect , I have a bubbly personality usually but when the headaches come full blown I'm very quiet and nothing makes sense!
I really feel for anyone with the same symptoms as me : (
But 2 days ago I went to see an osteopath and I explained my symptoms and she really sempt to understand she worked on my neck muscles which said are very knotted and gave me acupuncture ... When I left my symptoms did worsen and as a result I got migraine . However the next day for the first day in years my head was much better and had lifted loads! I'm going back next week.. I know it's early days but I'm really hopefully that she may have found the problem ! I will keep everyone posted as I wouldn't like anyone to suffer for years like me!

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TallulahA said on 03 November 2013

I experienced chronic tension headache two or three times a week causing lack of concentration and disorientation. This went on for several years and I tried just about everything in the article without success. My GP was unhelpful and painkillers rarely had any effect. Amitriptylene caused side effects that mimicked PMS and caused a serious problem at work as I lost my temper! I then found that a supplement of magnesium worked wonders. The headaches have not totally gone but they no longer ruin my life. Also, at the first sign of the headache, I use white Tiger Balm instead of painkillers which can prevent the headache developing.

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