Some tension headaches are nearly constant, with daily pain that may vary in intensity. Other tension headaches only occur once in a while. Symptoms usually start slowly and build.
Tension headache may cause:
Constant, steady pain and pressure
Dull and achy pain
Pain which may be felt on both sides of the head, in the forehead, temples, and the back of the head
Pressure may feel like a tight band around the head
Intensity that ranges from mild to severe and can vary during the day
Tightness in the head and neck muscles
Headaches can become so severe and constant that they interfere with normal activities and sleep.
You will be asked about your symptoms and medical history. A physical exam will be done. Diagnosis can be made on exam, based on specific features. The cause of the headaches however, may be more difficult to determine. A neurological exam may be done.
Imaging is not usually needed, but if pain is unusual or severe it may be done to look for other causes of the headache. Imaging tests include:
There are no specific cures for tension headaches, but they can be managed. Therapies aim to stop the headache and reduce the frequency of future episodes.
Treatment may include:
For occasional headaches, the following medication may be recommended to relieve pain:
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
Prescription pain relievers
Pain medications are most effective when taken at the first sign of pain and before it becomes severe. Overusing some over-the-counter medications may actually cause headaches. Continuous use of medications may create rebound pain when you stop taking the drug.
Taking a caffeine supplement with your pain reliever may improve pain relief.
The following medications may also be recommended to treat or prevent headaches:
Melchart D, Streng A, Hoppe A, et al. Acupuncture in patients with tension-type headache: randomized controlled trial. Brit Med J. 2005;331:376-379.
NINDS headache information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. Accessed February 15, 2018.
2/4/2015 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com: Derry CJ, Derry S, et al. Caffeine as an analgesic adjuvant for acute pain in adults. Cochrane Database Syst Rev. 2012 Mar 14;3.
Last reviewed March 2018 by
EBSCO Medical Review Board
Rimas Lukas, MD
Last Updated: 9/14/2016
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