Tension Headache: Causes, Symptoms, Diagnosis, Treatment, and Prevention
A tension headache, affecting millions of people worldwide, is characterized by dull, tight, or pressing pains on both sides of the head, often accompanied by stiffness in the neck, shoulders, or scalp on both sides. There are several kinds of tension headaches, from mild to severe, and they can last from 30 minutes to several days. They can interfere with daily activities such as work, school, or socializing.
Causes of Tension Headache
The exact cause of tension headache is not fully understood, but several factors may contribute to its occurrence, such as:
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Anxiety, depression, anger, or frustration can trigger tension headaches. Stress can also cause muscle tension in the head and neck area, which leads to pain.
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Poor posture, such as slouching, hunching, or holding the head awkwardly, can strain the muscles and nerves in the neck and head area, resulting in tension headaches. When you spend a long time on a computer, driving, reading, or using your smartphone, this can occur.
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A lack of sleep, irregular sleep patterns, or poor sleep quality can affect the body's ability to deal with stress and pain, leading to tension headaches. Sleeping too much or too little can also disrupt the body's natural rhythms, which can affect the nervous system and cause headaches.
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Food and drink: Certain foods and drinks, such as caffeine, alcohol, chocolate, cheese, or processed meats, can trigger or worsen tension headaches. Skipping meals, fasting, or dehydration can also lower blood sugar levels.
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In women, hormonal changes, such as those during menstruation, pregnancy, menopause, or oral contraceptive use, can affect the blood vessels and nerves in the head and neck area, causing tension headaches.
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Overuse or misuse of painkillers, such as aspirin, ibuprofen, or acetaminophen, can lead to rebound headache, a type of tension headache that occurs after the medication wears off. In addition to antidepressants, antihistamines, or blood pressure drugs, tension headaches can also be exacerbated or caused by other medications.
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Tension headaches can also be caused or worsened by eye strain, sinus infection, cold, flu, allergies, dental problems, or head injuries.
Symptoms of Tension Headache
The main symptom of tension headache is a dull, tight, or pressing pain on both sides of the head, usually in the forehead, temples, or back of the head. The pain may spread to the neck, shoulders, or scalp, and may feel like a band or a weight around the head. It may be continuous or intermittent, with mild to severe intensity. Physical or mental activity, loud noise, or strong odor may worsen the pain.
Other symptoms that may accompany tension headache include:
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Fatigue
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Irritability
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Difficulty concentrating
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Difficulty sleeping
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Sensitivity to light or sound
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Nausea or vomiting (rare)
Diagnosis of Tension Headache
Doctors will ask about the history, frequency, duration, intensity, location, triggers, and any other symptoms or conditions that may be related to tension headache in order to diagnose tension headache. The doctor will also conduct a physical examination to determine if the head, neck, eyes, ears, nose, mouth, or throat are infected, inflamed, or injured. Tests, such as blood tests, urine tests, or imaging tests, may also be ordered to rule out other causes of headache, such as migraine, cluster headache, sinusitis, or brain tumors.
In tension headache, there is no specific test, but a doctor may use some criteria to determine whether the headache is episodic or chronic. In an episode of tension headache, it lasts from 30 minutes to 7 days. In a chronic tension headache, it lasts for more than 3 months, and occurs more than 15 times per month.
Treatment of Tension Headache
The main goals of tension headache treatment are to relieve the pain, prevent the headache from recurring, and reduce the stress and muscle tension that may worsen the headache.
The treatment options for tension headache include:
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A mild to moderate tension headache can be relieved with over-the-counter painkillers like aspirin, ibuprofen, or acetaminophen. If taken too frequently or for too long, these drugs can lead to side effects, such as stomach upset, liver damage, or kidney damage, as well as rebound headaches. For severe or chronic tension headaches, as well as for those who do not respond to over-the-counter medications, prescription drugs can be used, such as muscle relaxants, antidepressants, or antiseizure medications. Also, these drugs may interfere with other drugs and substances, such as alcohol, caffeine, or herbal supplements, and may cause drowsiness, dry mouth, weight gain, or sexual dysfunction. Consequently, these drugs should be used under the guidance of a doctor, and dosage and duration should be adjusted accordingly.
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Stress and muscle tension that may cause or worsen tension headaches can be reduced using non-medication therapies, including relaxation techniques, biofeedback, cognitive-behavioral therapy, acupuncture, massage, physical therapy, or exercise. Besides improving mood, sleep, and coping skills, these therapies can also make medications more effective. Individuals can use these therapies alone or in combination with medication, depending on their preference and needs.
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Lifestyle changes: By avoiding or limiting triggers of tension headache, such as stress, caffeine, alcohol, or certain foods, maintaining a regular sleep pattern, eating a balanced diet, drinking enough water, quitting smoking, or managing other medical conditions, such as high blood pressure, diabetes, or depression, tension headaches can be prevented or reduced in frequency and severity. A person's overall health and well-being can also be improved by these changes.
Prevention of Tension Headache
You can prevent tension headache by identifying and avoiding factors that may cause or worsen the headache, such as stress, posture, sleep, diet, hormones, medication, or other factors. Some tips to prevent tension headache include:
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Manage stress: Stress is one of the most common triggers of tension headaches, so it is important to find healthy ways to cope with stress, such as meditation, yoga, breathing exercises, hobbies, music, or social support. If necessary, seek professional help, set realistic goals, prioritize tasks, or delegate responsibilities.
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Improve posture: Poor posture can strain the muscles and nerves in the head and neck area, which can cause tension headache. Therefore, it is advisable to maintain a good posture, such as keeping the head, neck, and spine aligned, avoiding slouching, hunching, or holding the head in an awkward position, adjusting the height and angle of the computer screen, keyboard, and chair, stretching and moving frequently, or using ergonomic devices, such as pillows, cushions, or supports, to relieve head and neck tension.
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For the nervous system to function properly and for the body to heal and restore, sleep is essential. Stress and pain can be more difficult to cope with when the body lacks sleep, irregular sleep patterns, or poor sleep quality. Consequently, it is recommended that you get enough sleep, at least seven to nine hours a night, follow a regular sleep schedule, avoid caffeine, alcohol, or nicotine before bedtime, create a calm, comfortable sleeping environment, or practice good sleep hygiene, such as avoiding naps, screens, or stimulating activities before bedtime.
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Diet can adversely affect blood vessels and nerves in the head and neck area, resulting in tension headaches. Therefore, it is important to eat a balanced diet, which includes fruits, vegetables, whole grains, lean protein, and healthy fats, and is low in salt, sugar, and processed foods. A stable blood sugar level can also be maintained by avoiding or limiting foods and drinks that trigger or worsen tension headaches, such as caffeine, alcohol, chocolate, cheese, or processed meats, and by eating regularly, without skipping meals, fasting, or overeating. Keeping hydrated and preventing dehydration, which can cause headache, requires drinking at least 8 glasses of water every day.
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Regular exercise can reduce stress and muscle tension that lead to tension headaches, as well as improve blood circulation and oxygen delivery to the brain and other parts of the body. In addition to improving the immune system and overall health and well-being, exercise releases endorphins, which are natural painkillers and mood boosters. As a result, it is important to exercise regularly at least 30 minutes a day, 5 days a week, choosing an activity that is enjoyable, safe, and appropriate for the individual's fitness level and health condition. Warming up before and cooling down after exercise is also important, as well as avoiding overexertion, injury, or dehydration, which can cause headaches.
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For proper diagnosis and treatment of tension headaches, it is advisable to consult a doctor if the headache is severe, frequent, persistent, or interferes with daily activities. It may be possible to relieve tension headache pain and prevent its recurrence with medication, referral to a specialist, or other therapies recommended by a doctor. Additionally, a doctor can rule out other serious headache causes, such as migraine, cluster headaches, sinusitis, or brain tumors, which may require different or urgent treatment.
