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Tension–type headaches are a frequent type of headache that usually results in mild to moderate pain. Some people compare the sensation to a tight band encircling their head. These headaches are the most widespread variety, although their precise causes are not yet comprehensively grasped.
Fortunately, there are treatments accessible for tension–type headaches. Coping with these headaches typically involves maintaining healthy routines, exploring useful non–medication therapies, and considering over–the–counter pain relievers or, if required, antidepressants prescribed by a doctor.
Symptoms
Signs and Symptoms:
- Dull, aching pain in the head.
- Feeling of tightness or pressure across the forehead, sides, or back of the head.
- Tender scalp, neck, and shoulder muscles.
Types of Tension–Type Headaches:
- Episodic Tension–Type Headaches:
- Last from 30 minutes to a week.
- Frequent episodic headaches occur less than 15 days a month for at least three months.
- Frequent episodes might progress to chronic tension–type headaches.
- Chronic Tension-Type Headaches:
- Last for hours and can be ongoing.
- Considered chronic if they happen 15 or more days a month for at least three months.
If you experience any of the following indicators, it’s important to promptly seek emergency medical attention:
- Suddenly intense headache
- Headache accompanied by fever, stiff neck, cognitive confusion, seizures, double vision, muscle weakness, numbness, or speech issues
- Headache following a head injury, particularly if the headache worsens.
Causes
The precise cause of tension–type headaches remains uncertain. While earlier beliefs pointed to muscle contractions in the face, neck, and scalp triggered by emotions or stress, recent research challenges this view by indicating that muscle contractions might not be the underlying cause. The prevailing theory proposes that individuals experiencing tension–type headaches might have an amplified sensitivity to pain. This heightened pain sensitivity could lead to increased muscle tenderness, a frequent symptom of these headaches, and this, in turn, could arise from a pain system that has become more sensitive. Notably, stress is the most commonly reported trigger for tension–type headaches.
Diagnosis
In the case of chronic or recurring headaches, medical professionals may perform physical and neurological assessments to subsequently identify the specific type and underlying origins of the headaches through the following methods:
- History Taking
- Characteristics: Clarify whether the pain is characterized by pulsating sensations or if it remains constant, manifesting as dull, sharp, or stabbing.
- Intensity: Communicate the extent of pain’s severity by assessing its impact on daily functioning. This includes gauging the ability to work through headaches and any disruptions to sleep patterns.
- Location: Describe precisely where the pain is localized, whether it encompasses the entire head, is confined to one side, or concentrates on specific regions such as the forehead or behind the eyes.
- Imaging Tests: For individuals with atypical or complicated headache patterns, diagnostic tests are recommended to eliminate serious causes like tumors. The two primary imaging techniques employed are:
- Magnetic Resonance Imaging (MRI): Combining magnetic fields, radio waves, and advanced computing, MRI scans produce detailed images of the brain.
- Computerized Tomography (CT): Involving a series of computer–guided X–rays, CT scans offer comprehensive views of the brain’s structure.
Treatment
Some patients experiencing tension–type headaches may choose not to consult a doctor and, instead, attempt self–treatment. Unfortunately, repeatedly using over–the–counter pain relievers can lead to a different kind of headache called medication overuse headache.
Acute medications
Various medications, both over the counter and prescription, can help alleviate headache pain:
- Pain relievers: Common nonprescription options like aspirin, ibuprofen, and naproxen sodium are usually the first choice.
- Combination medications: These combine aspirin or acetaminophen with caffeine or a sedative, often providing better relief than single–ingredient options. Many of these are available without a prescription.
- Triptans and narcotics: Triptans work well for migraines and tension–type headaches, while opioids are seldom used due to side effects and addiction risks.
Preventive medications
Your doctor might prescribe medications to reduce the frequency and intensity of attacks, particularly if you experience frequent or chronic headaches unresponsive to pain relief and other treatments. Preventive options include:
- Tricyclic antidepressants: These, like amitriptyline and protriptyline, are commonly used for tension–type headache prevention. Side effects may encompass constipation, drowsiness, and dry mouth.
- Other antidepressants: Evidence also supports the use of antidepressants like venlafaxine and mirtazapine.
- Anticonvulsants and muscle relaxants: Medications such as gabapentin and topiramate may also help prevent tension–type headaches, although further research is necessary.
Be patient with preventive medications, as they may take a few weeks to become effective after building up in your system. Your doctor will track their progress, and it’s important to avoid excessive use of pain relievers during this time to ensure the effectiveness of the preventive treatment. Consult your doctor regarding pain reliever usage while on preventive medication.
