Tension Headaches

Tension Headaches

Just about everyone has experienced a headache and many of us accept headaches as an unavoidable part of our lives. The most common type are called tension headaches, which affect one in three people. When headaches occur at the end of a busy workday, they may be attributed to stress and muscle tension. The pain of tension headaches are mostly mild or moderate, and usually located on both sides of the head. People with tension headaches usually describe feeling pressure or a tight sensation and sometimes can be throbbing, like a migraine. Nausea can occur with severe tension headaches, but auras or other migraine symptoms are not a part of tension headaches.

Tension headaches that are mild and infrequent do not usually pose a significant problem, but if the pain is severe or frequent, and interferes with the daily activities, then more intense treatment may be needed.

For years it was assumed that tension headaches were brought on by tense muscles in the neck and at the base of the skull, and the tension was caused by psychological stress. We now know that the causes of tension headaches are more complicated than simple muscle tension and stress. There are biochemical changes in the brain similar to those seen in migraine and evidence suggests that the pain may come from the brain itself with muscle pain being secondary. It is quite possible that tension headaches may actually be a form of migraine. People with all three types of headaches often have tight and painful muscles which only adds to the pain that originates in deeper brain or spinal structures.

Treatment of Tension Headaches

When treating tension headaches, the first step is to eliminate factors that either cause headaches or make them worse. These factors include bad posture, bad body mechanics or weak neck muscles which requires a long term commitment similar to the treatment of neck pain. Simple techniques such as ice or NSAIDs will be sufficient to relieve an established headache.

However, when simple measures are not effective, more aggressive neck muscle strengthening, postural training and treatment with prescription medications may be necessary. Medications used are many of the same used for prevention of migraine headaches including antidepressants (notriptyline, amitryptiline) as well as beta blockers.

Although psychological stress is not the cause of tension headaches, it can make pain worse, therefore, stress reduction techniques and psychotherapy can be helpful. Chiropractic care and massage can also help, especially for periodic flare-ups of head pain.