Tension Headache

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KEY POINTS

• A tension headache is caused by tense muscles or stress. Most often the muscles are in your neck, shoulders, or scalp.
• Treatment to relive pain may include rest, stretches and massage, nonprescription pain medicine, ice, or moist heat.
• If taking care of yourself at home does not relieve a tension headache, your healthcare provider may recommend physical therapy, biofeedback, or a different pain reliever.

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What is a tension headache?

A tension headache is caused by tense muscles or stress. Most often the muscles are in your neck, shoulders, or scalp. Tension headaches are very common.

What is the cause?

Tension headaches may be caused by:

• Stress, such as family, work, finances, or health problems
• Anxiety or depression
• Sitting or standing in one position for a long time
• Injury such as from a car accident
• Getting too little or too much sleep
• Heavy smoking
• Drinking too much alcohol, or going through alcohol withdrawal
• Being somewhere that is too noisy
• Pushing your body too hard at work or playing sports
• Some medical conditions, such as sleep apnea or arthritis

Taking pain medicine too often for headaches can cause rebound headaches or drug-induced headaches. It can create a bad cycle: You have a headache, so you take pain medicine. When the pain medicine wears off it causes another headache, which causes you to take more medicine, which causes another headache. Examples of nonprescription medicines that can cause rebound headaches are aspirin, acetaminophen, and ibuprofen. Some prescribed pain medicines can also cause this problem. If you often take medicine for headaches, talk with your healthcare provider.

To learn about possible triggers and help you to avoid them, it will help if you keep a record of:

• When you have the headaches
• What part of your head, body, or face is affected
• What type of pain it is, such as sharp, dull, or pressure
• How bad the pain is and how long it lasts
• Other symptoms you have at the same time
• What makes the headache better or worse

What are the symptoms?

Symptoms usually last a few hours to a day. Symptoms may include:

• A feeling like a tight band is around your head
• An ache or dull and steady pain felt at the temples or affecting the whole head that worsens through the day, sometimes with a sore or stiff neck
• Trouble concentrating
• Trouble sleeping
• Your muscles might twitch or spasm. Sometimes your head may feel like it is throbbing.

How is it treated?

Most of the time, you don’t need to see your healthcare provider for treatment. Here are some things you can do to relieve a tension headache:

• Rest in a quiet, dark room until symptoms lessen or go away.
• Stretch and massage your neck, shoulders, and back.
• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on your neck, shoulders, and back every 3 to 4 hours for up to 20 minutes at a time.
• Put moist heat on tense muscles for up to 30 minutes to relieve pain. Moist heat includes heat patches or moist heating pads that you can buy at most drugstores, a warm wet washcloth, or a hot shower. To prevent burns to your skin, follow directions on the package and do not lie on any type of hot pad. Don’t use heat if you have swelling.
• Take a warm bath or hot shower.
• Take a walk or do some other type of physical exercise.
• Take nonprescription pain medicine as soon as you notice symptoms. Recognizing early warning signs and starting treatment right away can lower the pain and shorten the time you have the headache.

If taking care of yourself at home does not relieve a tension headache, your healthcare provider may be able to help. Tell your healthcare provider about all the medicines and supplements that you take. Your provider may recommend:

• Physical therapy
• Biofeedback therapy, which uses a machine to help you learn to control muscle tension
• A different pain reliever

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How long it will normally take to recover from each headache
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests. Contact your healthcare provider if you have new or worsening symptoms.

How can I help prevent tension headaches?

A healthy lifestyle may help:

• Eat a healthy diet. Don’t skip meals.
• Stay fit with the right kind of exercise for you.
• Limit caffeine.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example, take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink.
• Try to get at least 7 to 9 hours of sleep each night.

You are at risk for rebound headaches if you regularly take pain medicine for headaches 3 or more days every week or on more than 9 days per month. If you find that you are taking medicine for headaches this often, talk to your provider.

You can get more information from:

• American Migraine Foundation
  800-255- 2243
  http://www.achenet.org/
• National Headache Foundation
  800-843-2256
  https://americanmigrainefoundation.org/