Overview
A tension headache, often called a tension-type headache, is a widespread form of primary headache that produces a steady, pressing or tightening pain across the head. It commonly affects the temples, forehead and back of the head and may be felt in the eyes or neck. For general background on headaches see related information.
Symptoms and clinical features
Typical attacks are bilateral and described as a nonpulsing pressure or tight band around the head. Pain is usually mild to moderate and does not worsen substantially with routine physical activity. Nausea is uncommon; some people report sensitivity to light or sound but not both. Headache patterns are classically divided into episodic and chronic forms—the latter is defined by frequent or near-daily pain and may require different management strategies. For anatomy and symptom diagrams consult anatomy resources.
Causes and risk factors
The exact mechanism remains incompletely understood. Contributing factors include prolonged muscle tension in the scalp and neck, poor posture, stress, anxiety, sleep disturbance, and visual strain. In some people central nervous system pain-processing changes play a role, especially in chronic cases. Tension-type headache is more common in women and in adults of working age.
Common triggers
- Emotional stress or anxiety
- Poor posture or prolonged desk work
- Eye strain and uncorrected vision problems
- Irregular sleep or fatigue
- Caffeine withdrawal or medication overuse
Management and prevention
Initial treatment focuses on self-care and simple analgesics such as acetaminophen or nonsteroidal anti-inflammatory drugs taken appropriately. Nonpharmacologic therapies are important: physical therapy, posture correction, regular exercise, relaxation training, biofeedback, and cognitive-behavioral approaches can reduce attack frequency and severity. For chronic tension-type headache, a clinician may consider preventive medications (for example certain antidepressants) and referral to pain specialists. Avoid frequent use of painkillers to reduce the risk of medication-overuse headache; see trusted sources at treatment guidance.
When to seek medical attention and outlook
Most tension-type headaches are benign, but see a healthcare provider if headaches are new, progressively worse, unusually severe, or accompanied by neurological symptoms (weakness, speech changes, confused thinking), fever, or onset after age 50. A clinician will rule out secondary causes and discuss individualized treatment. With appropriate self-care and medical advice many people experience meaningful improvement in symptoms and quality of life.