Tension headaches are the most common type, accounting for an estimated 90 percent of all headaches. Causing mild to moderate pain in the head, neck or behind the eyes, these headaches may be episodic or chronic. Episodic tension headaches are defined as occurring less than 15 days out of the month while chronic occur for at least 15 days per month for more than six months. Chronic tension headaches are more common in women than in men.
Causes of Tension Headaches
Some tension headaches are caused by muscle contractions in the head and neck area while the underlying physical causes for others are unknown. One theory suggests that the production of nitric oxide, a compound that dilates blood vessels, may be involved; another points to faulty pain pathways that may be influenced by the neurotransmitter serotonin.
Tension headaches are most often triggered by external or internal stressors such as:
• Lack of sleep
• Irregular eating patterns or hunger
• Uncomfortable sitting position
• Poor posture
• Illness including cold, flu and sinus infection
• Cold temperatures
• Ingestion of caffeine or alcohol
Heightened sensitivity to pain and stress could also be a cause of tension headaches. This may be due to hyperexcitibility in specific neurons in the brain or problems with pain inhibition.
Tension Headache Symptoms
Symptoms of both episodic and chronic tension headaches tend to be similar with sufferers reporting dull head pain, a feeling of pressure in the forehead or of having a “band” around the head and tenderness in the forehead and scalp. Pain generally radiates throughout the entire head rather than being sequestered to one side or another. Some people report feeling more intense pain at particular points on the scalp, temples, shoulders or in the back of the neck.
Unlike migraines, tension headaches do not cause nausea, vomiting or problems with vision. Some may be accompanied by light or sound sensitivity, but these symptoms are rarer.
Treatments for Tension Headaches
Over-the-counter analgesics such as aspirin, acetaminophen and ibuprofen are commonly used to treat tension headaches. Some medications include a combination of these painkillers and another substance such as caffeine or a sedative to help relieve tension. In cases of extreme pain or tension headaches that last despite treatment, strong medications such as barbiturates or narcotics may be prescribed for short-term use.
Tricyclic and SSRI antidepressant medications have been used successfully to treat tension headaches in some sufferers. Whether these work due to a direct effect of serotonin on the genesis of tension headaches or by making patients more able to deal with stress is unclear. In cases where muscle contractions are known to be the cause, anticonvulsant or muscle relaxant medications may provide relief.
Tension headaches may also be addressed with home remedies, including:
• Taking regular breaks from computer work to avoid eyestrain
• Applying a hot or cold compress to painful areas
• Taking a hot shower
• Gentle self-massage of the head and neck areas
• Drinking tea with calming herbs such as peppermint or chamomile
• Improving posture
• Practicing stress reduction techniques
Though tension headaches are common, the condition is treatable with a variety of medical and home remedies and should resolve within a few hours to a few days.