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Headaches - tension

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An in-depth report on the causes, diagnosis, treatment, and prevention of common headaches.


What Are Tension-Type Headaches?

Tension-type headaches are the most common type of headache, accounting for about half of all headaches. The pain is usually mild-to-moderate in intensity, with a steady pressing or tightening quality (like a vise being squeezed around the head). The headache is not accompanied by nausea or vomiting, and the pain is not increased by routine physical activity such as walking or climbing stairs. A tension-type headache attack can last anywhere from 30 minutes to an entire week.

Who Gets Tension-Type Headaches?

Women are more likely to get tension-type headaches than men. Nearly everyone will have at least one tension-type headache at some point in their lives. Many people who have migraine headaches also have tension-type headaches.

What Is The Difference Between Tension-Type Headaches and Migraine Headaches?

Migraines and tension headaches have some similar characteristics, but also some important differences:

Migraine pain is usually throbbing and while tension-type headache pain is usually a steady ache.

Migraine pain often affects only one side of the head while tension-type headache pain typically affects both sides of the head.

  • Migraine headaches, but not tension-type headaches, may be accompanied by nausea or vomiting, sensitivity to both light and sound, or aura.
  • Treatment of tension-type headache focuses on relieving pain when attacks occur, and preventing recurrence of attacks. Most tension-type headache attacks respond to simple over-the-counter pain relievers such as aspirin, ibuprofen (Advil, Motrin, generic), or naproxen (Aleve, generic).

    Patients who have two or more tension-type headache attacks each month should talk to their doctors about preventive therapy. This may include a tricyclic antidepressant, such as amitriptyline (Elavil, generic), combined with behavioral therapies. Behavioral treatment approaches include relaxation therapy, biofeedback, stress management, and cognitive-behavioral therapy.


    Most people have had headaches. There are many different kinds of headaches, and they range from being an infrequent annoyance to a persistent, severe, and disabling medical condition.

    Brain tissue itself does not generate sensations of pain, so the brain is not what hurts when you have a headache. Rather, the pain occurs in some of the following locations:

    • The tissues covering the brain
    • The attaching structures at the base of the


    • Muscles and blood vessels around the scalp, face, and neck

    Doctors categorize headaches as either primary or secondary. The category helps to distinguish the many different kinds of headaches and to determine right treatments for each.

    Primary and Secondary Headaches

    A headache is considered primary when it is not caused by another medical condition or disease. Most primary headaches fall into three main types: tension-type, migraine, and cluster headaches.

    • Tension-type headache is the most common primary headache and accounts for 90% of all headaches.
    • Migraines are the second most common primary headaches. Migraine is referred to as a neurovascular headache because it is most likely caused by an interaction between blood vessel and nerve abnormalities.
    • Cluster headache is a less common type of primary headache that is sometimes referred to as a neurovascular headache.

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    Headaches are usually caused by muscle tension, vascular problems, or both.

    Secondary headaches are caused by other medical conditions, such as sinus infections, neck injuries, and strokes. About 2% of headaches are secondary to abnormalities or infections in the nasal or sinus passages, and they are commonly referred to as sinus headaches.

    Chronic Daily Headaches

    Chronic daily headaches are defined as any benign headache that occurs at least 15 days a month and is not associated with a serious neurologic abnormality. Most people with these headaches have them daily or almost daily and they can be quite debilitating.

    Chronic daily headaches can begin as tension headaches, migraines, or a combination of these or other headache types. Chronic daily headaches are subdivided into two categories:

    • Short-duration headaches, or those lasting fewer than 4 hours. The most common short-acting chronic headaches are cluster headaches.
    • Long-duration headaches, which last more than 4 hours. Tension-type headaches are the most common type of long-duration chronic (recurring) headaches and, in fact, the most common type of chronic headaches in general.
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      Tension-Type Headaches

      Tension-type headaches, also called muscle contraction headaches or simply tension headaches, are the most common of all headaches. They are classified into four types: where to report drug activity

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