Understanding and Managing Your Tension Headache

Tension headaches are the most common type of headache disorder that millions of people suffer from. While having a tension headache is rarely debilitating, it can still dampen your mood and prevent you from getting through the day comfortably.

So what exactly is a tension-type headache and how is it treated? Tension headache pain feels like a band tightening around the head. The main cause of tension headaches is still unknown, but there are a few headache treatment options to alleviate muscle tension and pain. Some of them include trigger point injections, alternative medicine, and polypharmacy.

Everything to Know About Tension-Type Headache (TTH)

Tension-type headache (also known as “stress headache”) is a common headache disorder that affects about 46% of adults. When an individual has a tension headache, they feel mild to moderate pain around their head, neck, or face. It can also feel like a tight band around the head.

Most people try to endure their tension headaches or take over-the-counter medicines to counter the pain. Although this treatment is effective for most people, frequent tension headaches should be consulted with a doctor to determine its cause and find the right conditions for treatment.

4 step tension Headache Process

How Tension Headaches Feel

There are over a hundred different types of headaches, so recognizing how tension headaches feel can help you find the right treatment for them more quickly. People experience tension headache pain differently, but most of their symptoms feel like something squeezing both sides of their heads together. Others said their head pain is like having a tight band around their head.

If you have a tension headache, you may feel the pain that’s:

  • Constant but not throbbing
  • Mild to moderate, but not severe
  • Felt on both sides
  • Gets better after an OTC pain relief medication
  • Felt in the scalp, temples, neck, or shoulder muscles

Aside from the type of headache pain that patients experience, another important thing to consider is the duration of the tension headache. Here are the 2 main types of tension headaches according to the International Headache Society:

  • Episodic tension headache refers to headache pain that lasts from about 30 minutes up to a week. The patient may experience episodic tension-type headaches for less than 15 days a month for 3 months. If left untreated, this headache disorder may develop into a chronic tension-type headache.
  • Chronic tension headache refers to the kind of tension-type headache that lasts for a few hours. Patients may experience continuous headache pain in their heads. A chronic tension-type headache may occur for an average of at least 15 days a month for 3 months.

TTH vs. Migraine Headache

Many people find it difficult to distinguish tension headaches from migraine headaches because of their similarities. But patients who have frequent tension headaches are also bound to have migraines.

The main difference between these conditions is that tension-type headaches don’t come with other migraine symptoms. Patients don’t experience nausea, visual disturbances, and vomiting when they have tension headaches. Some patients may experience sensitivity to sound or light during a stress headache episode, but this symptom is highly uncommon.

Migraine pain is also a lot more severe than tension headaches. It comes as pounding or throbbing pain that is focused on one side of the head. Knowing these differences comes in handy when managing headache pain using different treatment options.

Possible Causes of Tension Headaches

Medical researchers and doctors can’t pinpoint the exact cause of tension headaches yet, but most cases are linked to having tight muscles in the face, head, and neck. Other studies explore the relationship of tension headache pain to the activation of peripheral afferent neurons – the nerve cells that are responsible for interacting with pain receptions in the body.

Although the cause of tension headaches is still unclear, doctors still find similar triggers among their patients who experience the headache disorder.

You may feel this condition if you’re exposed to a headache trigger, such as:

  • Physical stress
  • Emotional stress or mental health disorders
  • Dry eye and eye strain
  • Fatigue, flu, or sinusitis
  • Lack of sleep and water intake
  • Skipping meals
  • Too much caffeine and alcohol
  • Dental problems
  • Poor posture

Diagnosing Tension-Type Headache

Although chronic pain caused by frequent tension-type headaches can be extremely disruptive, most medical experts agree that the headache disorders themselves don’t usually cause serious health concerns.

However, they may be a sign of an underlying health issue in some cases – like thyroid disease or a tumor. It may also be a symptom of a primary headache disorder like chronic migraine, so patients over the age of 50 are advised to keep a headache diary and consult a doctor immediately.

Doctors have 2 different ways to diagnose tension-type headaches: evaluating the patient’s pain description and conducting imaging tests. They can learn about a patient’s headache based on the pain location, intensity, and characteristics. Imaging tests like MRI and CT scans are usually reserved for complicated headaches to rule out underlying serious health conditions.

How to Treat Tension-Type Headaches at Advanced Headache Center

Patients don’t usually seek medical attention immediately when they experience tension-type headaches. They may take a pain reliever instead to get rid of their headache pain. However, repeated use of OTC pain medicine may lead to another type of headache – medication overuse headache or rebound headache.

At Advanced Headache Center, we recommend different treatment plans based on the patient’s suffering and headache triggers. We may prescribe one or more of the following treatment plans for your tension-type headache:

1) Trigger Point Injections

Trigger point injections are performed to reduce headache pain by administering the medication into a nearby trigger point, a small and tender knot that may form in muscles or fascia. It’s a non-surgical, outpatient procedure that only takes a few minutes to complete in a doctor’s office.

During the procedure, the doctor locates a trigger point and cleans it before inserting the needle into the skin. The injection contains an anesthetic mixture that causes the trigger point to relax. Most patients experience relief after one trigger point injection while others might need additional injections.

2) Rational Polypharmacy

Rational polypharmacy uses more than one pain medication to treat the patient’s headache pain. A combination of rescue or preventive medications are especially helpful for certain headache disorders like chronic daily headache and tension headache, but it’s crucial to know which ones go well together to avoid rebound headache.

At Advanced Headache Center, our headache specialist closely works with the patient to determine the best course of treatment without worsening their symptoms. We may recommend medicines that prevent or stop episodic headaches.

3) Alternative Medicine

For patients who want to avoid medications, there are a few non-traditional and alternative therapies that can help relieve tension headache pain. Here’s what we offer at Advanced Headache Center:

  • Physical therapy – This treatment option is extremely effective in treating headaches because it’s customizable depending on the patient’s needs. It may involve relaxation exercises, massage therapy, and others to relieve pain and strengthen muscles.
  • Acupuncture – This popular relaxation technique is a form of traditional Chinese medicine that helps alleviate many types of pain conditions. It works by inserting hair-thin needles into specific parts of the body to stimulate the nervous system and relieve headache pain.
  • Chiropractic care – Headaches and other pain conditions caused by spine misalignment are best treated with spinal manipulation or chiropractic adjustments. It relieves the tension from the system, resulting in long-lasting pain relief in the back, neck, shoulders, and head.

Highly-Effective Treatments for Your Tension Headache at Advanced Headache Center

Tension headaches are quite common, but patients should never try to self-diagnose or self-medicate. As soon as your headache pain worsens or starts affecting your quality of life, make sure to consult a headache specialist immediately for an accurate diagnosis and well-designed treatment plans.

At Advanced Headache Center, we offer a wide range of different treatment options for patients with tension headaches and other headache disorders. We always make sure to correctly determine the patient’s condition first before deciding on the best pain medications, pain relief treatments, or alternative integrative procedures for them.

Contact us today to make your first appointment with us.

Updated on May 8, 2024 by Dr. Amr Hosny (Headache Specialist) of Advanced Headache Center

Amr Hosny, MD, MBA, AQH

Dr. Hosny is an Ivy League Trained, UCNS-accredited, board-certified headache specialist who offers the latest preventive and abortive treatments to provide safe and effective head pain relief. As an active member of prominent organizations and professional societies that advance headache science, education, and management, such as the National Headache Foundation, Dr. Hosney specializes in diagnosing and treating a wide range of head pain disorders, including tension headaches, migraines, and cluster headaches, to name a few.

Dr. Hosny's reputation for enhancing headache care quality through the use of the most effective and technologically advanced treatment options for persistent primary and secondary chronic headaches has been acknowledged by Castle Connolly and Healthgrades, where he has received over 200 positive reviews. Dr. Hosny is also recognized as a distinguished New York City physician and headache specialist by New York Magazine.

More about Dr. Hosny
Advanced Headache Center 41 5th Avenue,
New York, NY 10003
(646) 763-2222