Tension headache is a spreading, steady head pain that can be mild or severe.

Tension Headache: Areas of Pain

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Tension headaches develop when muscles in the neck, face, and scalp contract.

The cause is not known. Genes are thought to play a role.

Risk Factors

This problem often starts in people who are 25 years of age and older. It is also more common in women.

Other things that may raise the risk are:

  • Stress
  • Mental tension
  • Being emotionally upset


Some tension headaches happen often. Others happen only once in a while. They do not often get in the way of daily activities.

Tension headaches are:

  • Felt on both sides of the head
  • Have a pressing or tightening feeling


The doctor will ask about your symptoms and health history. A physical exam will be done. A neurological exam may also be done. This is often enough to make the diagnosis.


The goal is to manage symptoms and lower the risk of future headaches. Choices are:


The doctor may advise:

  • Over-the-counter pain medicine, such as ibuprofen
  • Prescription pain relievers

Taking a caffeine supplement with a pain reliever may also help.

Antidepressants may also be given to lower the risk of future headaches.

Other Management

Other ways to manage headaches are:

  • Physical therapy, such as massage, exercise, treatments to improve posture, and hot and cold packs
  • Stress management and relaxation methods
  • Biofeedback to learn how to control muscle tension


A person who gets tension headaches may be given antidepressants to lower the risk of getting them in the future.


American Headache Society

National Headache Foundation


Canadian Headache Society

Help for Headaches


Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.

Headache information page. National Institute of Neurological Disorders and Stroke website. Available at: Updated December 31, 2019. Accessed April 9, 2020.

Tension-type headache. EBSCO DynaMed website. Available at: Updated February 8, 2017. Accessed April 9, 2020.

Tension-type headache. National Headache Foundation website. Available at: Accessed April 9, 2020.

Last reviewed February 2020 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 4/9/2020