Overview

Tension headache involves intermittent episodes of head discomfort that are mild to moderate in intensity, include non-throbbing "tightness" or "pressure," generally on each side of the top , and aren't aggravated by routine physical activity. Nausea, vomiting, and light/sound sensitivity are rarely present.

Tension headache may last from 30 minutes to 7 days, occurring on more than 1 but fewer than 15 days a month. If headaches are present 15 or more days during a month, the strain headache is taken into account chronic headache (see Chronic headache topic). People who use pain medications for tension headaches, especially if used regularly, are more susceptible to developing chronic headache . In some cases, not treating the strain headache in the least , called undertreatment, also can cause the headache to become chronic headache .

Immediately seek medical attention if you or someone you are caring for experiences any of the following:

Ø  Stiff neck and a high fever associated with headache

Ø  Sudden onset of a severe headache

Ø  Loss of motor function, the ability to think clearly, or convulsions associated with headache

Ø  Head injury

Ø  Increased intensity and/or frequency of headaches

Who's at risk?

Tension-type headache is a little more common in women than men, with onset usually between ages 20 and 30. This type of headache becomes less frequent with age in both sexes. Factors such as fatigue, stress, depression, and anxiety are often present in people with tension headaches. The underlying explanation for head pain is assumed to involve a "resetting" of the absolute threshold within the brain toward greater sensitivity over time.

Signs and Symptoms

This headache syndrome is most notable for its absence of migraine-like features: there's no pulsating sensation, no necessity to lie still during a quiet, dark room. There is generally no history of migraines. People suffering from tension headache often do not stop what they are doing, noting that the headache is a nuisance but not incapacitating. If more severe, headaches can impair concentration, lessen appetite, and make those affected irritable. Tension headache often involves large portions of the head, frequently starting and perhaps staying in the back of the head, neck, and shoulders, with a band-like sensation of pressure in these areas. These regions can also be tender to touch.

Self-Care Guidelines

Many people take non-steroidal medications like ibuprofen or acetaminophen in an effort to lessen their headaches, which does initially give them the result they are looking for. However, when tension headaches become regular, these medications can contribute to worsening of the headache syndrome. For this reason, if headaches are frequent (ie, 2–3 times a week), generally harmless medications, such as ibuprofen or acetaminophen, should be taken only under guidance by a physician.

When to Seek Medical Care

The majority of tension headaches remain episodic and harmless. However, more serious medical conditions, such as brain tumors and inflammation of blood vessels, can be nondescript and resemble tension headaches. A new headache, one that's significantly different from past headaches, and protracted or changing headaches always require the eye of a doctor.

Contact your doctor in the following situations:

Ø  You develop new symptoms not typical of prior headaches.

Ø  A particularly severe headache occurs.

Ø  Alteration or loss of consciousness occurs.

Ø  Headache persists longer than 3–4 days (unless this is your usual pattern).

Ø  Current therapies/treatments are not working.

Ø  Fever and neck pain or stiffness are present.

Ø  Headache symptoms interfere with activities of daily living (eg, eating, bathing, working, etc).

Treatments Your Physician May Prescribe

Simple pain medications are useful for headaches that happen sporadically and may be prescribed in limited amounts by your doctor.

Lifestyle changes are vital in treating tension headaches. The objective is to eliminate influences that precipitate headaches before they become chronic. Well-defined expectations, education, and shut consultation together with your care provider are essential to success in controlling symptoms. Treatments and methods which will reduce tension headaches include:

Ø     Physical therapy to work on posture and relax neck, shoulder, and back muscles

Ø     Addressing any anxiety and depression

Ø     Learning how to control frustration/anger through relaxation therapies / hypnosis / biofeedback

Ø     Adjusting physical/lifestyle habits that may be contributing to the headaches (eg, obesity, snoring, diet, poor sleep habits, sedentary lifestyle)

Ø     Dietary monitoring for triggers, elimination of caffeine

Ø     Chronic medication overuse/misuse

Ø     Cognitive-behavioral therapy – talk therapy with a trained counselor, designed to identify stressors and develop coping strategies to minimize their effect on behavior

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