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Health Blog by Dr.Uday Nair


Tension headaches are very common, affecting up to 80% of people. Unfortunately, they're also among the most neglected and difficult types of headaches to treat.
With a tension headache, the pain often starts at the back of your head and moves forward, so that it eventually includes your neck, scalp, and head. It' s often described as feeling like you have a tight band across your head.

Although tension headaches can be painful, they are rarely a sign of a more serious illness. A combination of lifestyle changes, relaxation techniques, and traditional and complementary therapies can help reduce the number of tension headaches you have.


Tension headaches are one of the most common forms of headaches. They may occur at any age, but are most common in adults and adolescents.
If a headache occurs two or more times a week for several months or longer, the condition is considered chronic. Chronic daily headaches can result from the under- or over-treatment of a primary headache.
Rebound headaches are headaches that keep coming back. They may occur if you overuse painkillers.
Tension headaches occur when neck and scalp muscles become tense, or contract. The muscle contractions can be a response to stress, depression, a head injury, or anxiety.
Any activity that causes the head to be held in one position for a long time without moving can cause a headache. Such activities include typing or other computer work, fine work with the hands, and using a microscope. Sleeping in a cold room or sleeping with the neck in an abnormal position may also trigger a tension headache.

Other triggers of tension headaches include:
  • Alcohol use
  • Caffeine (too much or withdrawal)
  • Colds, the flu, or a sinus infection
  • Dental problems such as jaw clenching or teeth grinding
  • Eye strain
  • Excessive smoking
  • Fatigue or overexertion 
Tension headaches can occur when you also have a migraine. Tension headaches are not associated with brain diseases.

Signs and symptoms

  • Dull, aching head pain
  • The sensation of tightness or pressure across your forehead or on the sides and back of your head
  • Tenderness on your scalp, neck and shoulder muscles
  • Occasionally, loss of appetite
A tension headache can last from 30 minutes to an entire week. You may experience these headaches only occasionally, or nearly all the time. If your headaches occur 15 or more days a month for at least three months, they're considered chronic. If you have headaches that occur fewer than 15 times in a month, your headaches are considered episodic. However, people with frequent episodic headaches are at a higher risk of developing chronic headaches.
The headache is usually described as mild to moderately intense. The severity of the pain varies from one person to another, and from one headache to another in the same person.

Tension headaches are diagnosed primarily based upon reported symptoms, but a thorough medical exam, which may include other tests or procedures, may be used to rule out underlying diseases or conditions.
Tracking and sharing information about your headache with your doctor helps with the process of making an accurate diagnosis.If the history is consistent with tension-type headaches and the neurological exam is normal, no further diagnostic testing may be necessary. However, if the headache is not found to be the primary problem, then other tests may be needed to determine the cause.
Tests which may be used to determine the cause of a tension headache may include:
  • Blood testsVarious blood chemistry and other laboratory tests may be run to check for underlying conditions.
  • Sinus X-rays. A diagnostic imaging procedure to evaluate for congestion or other problems that may be corrected.
  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
  • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.


There are many different treatments for tension headaches, which respond well to both medication and massage. If these headaches become chronic, however, they are best treated by identifying the source of tension and stress and reducing or eliminating it.


Tension headaches usually respond very well to such over-the-counter analgesics as aspirin, ibuprofen, or acetaminophen. However, some of these drugs (especially those that contain caffeine) may trigger rebound headaches if discontinued after they are taken for more than a few days.
More severe tension headaches may require combination medications, including a mild sedative such as butalbital; these should be used sparingly, though. Chronic tension headaches may respond to low-dose amitriptyline taken at night.


Massaging the tense muscle groups may help ease pain. Instead of directly massaging the temple, patients will get more relief from rubbing the neck and shoulders, because tension headaches can arise from tension in this area. In fact, relaxing the muscles of the neck can cut the intensity and duration of tension headaches at least in half.
To relax these muscles, the neck should be rotated from side to side as the shoulders shrug. Some people find that imagining a sense of warmth or heaviness in the neck muscles can help. Taking three very deep breaths at the first hint of tension can help prevent a headache.
A gentle fingertip massage over the area just in front of and above the ears (temporal area) may also reduce the pain.

Alternative treatment

Eliminating the source of the tension as much as possible will help prevent tension headaches.Acupuncture may be helpful in treating some chronic tension headaches. Homeopathic remedies and botanical medicine can also help relieve tension headaches. A tension headache can also be relieved by soaking the feet in hot water while an ice cold towel is wrapped around the neck.

Please remember-If tension headaches are a symptom of either depression or anxiety, the underlying problem should be treated with counseling, medication, or a combination of both.

Prognosis and Prevention

Tension headaches often respond well to treatment, and do not cause serious medical problems. However, chronic tension headaches can have a negative impact on the quality of life and work.

If the doctor has examined you without finding any serious cause for the headaches, these tips should prove helpful.
  • Avoid excessive use of alcohol and tobacco.
  • Engage in correct posture while sitting and working. The type of chair you use is important. It should be one that maximises comfort and good posture and may need to be adjusted to suit your needs.
  • Perform relaxation techniques on a consistent basis.
  • Get plenty of fresh air and exercise.
  • Avoid triggers like being over-tired or intensely hunger..

Please Note

Notify your doctor if you have any of the following:
  • Changes in vision
  • Difficulty speaking
  • Numbness or tingling in your arms or legs
  • Marked change in severity of your headache
  • Sudden onset of a fever with a headache
  • Difficulty walking

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