Tension headaches are the most common type of headaches among the five main types of headaches. People suffering from tension headaches usually have a mild to moderate diffuse pain in head, associated with a feeling of tightness surrounding their head. Although tension headaches are common and frustrating to deal with, the real cause of this type of headache is undetermined yet.

What Are the Tension Headache Symptoms?

A tension headache is described as a diffuse (you can’t localize the pain in a specific area) aching or pressure, occasionally associated with head muscles tenderness. The pain can be on both sides of the head or felt more on the front, temporal bone, or back of the head. Sometimes, the pain may radiate to the neck and shoulders.

The symptoms do not impair the individual from their usual daily activities, although they can be quite annoying and depressing. The pain is usually mild to moderate in intensity, with no other symptoms such as nausea, vomiting, or hypersensitivity to sound or light.

People complaining of tension headaches notice that the pain starts gradually towards the end of the day and in particular when they go through stressful periods. However, tension headaches are not accompanied by a prodrome or a period in which a person can sense that a headache is on its way.

When to Visit a Physician

You need to see a doctor if:

• Your daily routine activities are impaired or you require taking medicine more than two times a week to deal with the pain.
• The pattern of headaches changes or the symptoms of tension headache feel different than usual.

On occasion, headaches may be a symptom of a dangerous medical condition such as an aneurysm (rupture of a weakened artery) or a brain tumor.

When to Go to the Emergency Immediately

If you have any of these symptoms apart from usual tension headache symptoms, seek emergency medical help:

• Sudden, severe headache
• A headache that is associated with increased temperature, neck stiffness, mental status changes, seizures, diplopia (double vision), muscle weakness, tingling sensation, or speech impairment
• The headache occurring after you have an injury to the head, especially if there is worsening of the headache

What Causes Tension Headache?

Although this type of headaches has no definite cause, there are a variety of contributing and exacerbating factors that can trigger a tension headache. As long as these triggers are present, there is high probability that tension headaches may become recurrent and chronic.

Some of the common triggers are:

• Chronic stress environment
• Tiredness
• Anxiety and depression
• Strenuous physical exercise
• Holding the head in one position for long duration of time
• Too much or not enough sleep
• Jaw clenching and teeth grinding
• Skipping of meals

These tension headache triggers are variable, depending on the person.

How to Treat Tension Headache Symptoms

1. Painkillers

OTC (over-the-counter) drugs are usually prescribed for treating tension headaches. Although they are relatively safe, you should not take these drugs such as ibuprofen, paracetamol, and aspirin regularly. The reason behind the caution is to prevent medication-induced headaches. The symptoms of medication-induced headaches are the same as tension headaches; thus you may think it’s the same headache and you take more OTC drugs. So, to reduce this complication, you should not take them for more than two days in a week. Also, it is advised to use these drugs when a headache develops and never use them to prevent tension headaches.

Concerning the opiates such as morphine and codeine, they are not usually given to treat a tension-type headache. Opiates can cause drowsiness and sedation; thus it's counteractive to be given during the day. In addition, they are the most likely to result in a medication-induced headache.

2. A Diary of the Cause of the Headache

It can be helpful to track your headaches using a diary if the headaches are recurring frequently. During the day, write down the time, place, frequency, and intensity of each headache. Also, you can note down anything you did that may have resulted in the headache. On the long run, a pattern may appear and you may actually find a trigger factor that you can avoid. For instance, eye strain, hunger, anger, stress, bad posture, etc.

Certain physicians suggest reviewing the diet. Caffeinated drinks, chocolate, alcohol, and cheese can all trigger tension headache symptoms. Other doctors prefer eating a healthy balanced diet, including a combination of slow-release energy foods along with less intake of refined carbs and sugars.

3. Alternative Therapy

Nontraditional therapies can be used as an alternative to medication to help you treat tension headaches. These therapies include:

• Acupuncture: Acupuncture practitioners use disposable and extremely thin needles to relieve chronic headaches temporarily. The American Academy of Medical Acupuncture website has referrals to physicians who use acupuncture as a treatment option.
• Massage: Massage can have a stress-relieving effect, which helps in reducing tension headaches. If your headaches are associated with tender, tight muscles, you may find massage extremely helpful in reducing the pain.
• Deep breathing, behavior therapies and biofeedback: There are numerous beneficial therapies that involve relaxation and meditation techniques, including deep breathing, biofeedback, and behavior therapies.

4. Lifestyle Changes and Home Remedies

Sometimes all you need is good rest and a long relaxing shower to release the tension. If you want to reduce the pain and its frequency, you can try some of the following:

• Reduce stress. Organizing your work and planning your day is a good first step into stress management. This way you will have extra time to rest your body. But, you can't predict the future. If you find yourself drowning in stress, try some stress managing techniques such as progressive muscle relaxation, guided imagery, yoga, and meditation, and avoid negative thoughts.
• Keep a good posture. Maintaining a good posture prevents your muscles from tensing and causing tension headaches at the end of your work day. While standing, keep your shoulders back, and pull in your buttocks and abdomen. While sitting, keep your thighs parallel to the ground and try to pull your head from a slumped position.
• Exercise. People who do exercise regularly report that their tension headache frequency is reduced. Simple exercises such as walking, jogging, and swimming are worth a try.