Tension headache, also known as muscle contraction headache, is experienced as a tight band around the head. It is diffuse, mild to moderate in nature. A tension-type headache is one of the commonest headaches suffered by people all over the world. However, the cause for it is not clear. Treatment comprises of medications, following a healthy lifestyle and relaxation techniques.
Types of Tension Headaches
Tension Headache is of 2 Types
- Episodic Tension Headaches: These headaches can last anywhere from half an hour to one week. Repetitive episodic tension headaches can become chronic in nature.
- Chronic Tension Headaches: This is an unrelenting type of tension headache and can last for hours. If a patient is having tension headaches for more than 15 days in a month and for three months, then they are considered as chronic tension headaches.
Causes of Tension Headaches
- The exact cause of tension headache is not clear. Experts believe that tension headaches occur as a result of muscle contractions in the scalp, face and neck or due to increased emotions such as stress or sadness.
- Another theory is an increased sensitivity to pain and stress makes a person more prone to tension headaches. A sensitized pain system gives rise to increased muscle tenderness, which is a symptom of tension headache.
- One of most common triggers for tension headaches is stress.
Risk Factors for Tension Headaches
- Women are more prone to suffer from tension headaches than men.
- The risk of suffering from tension headaches increases after the age 40.
Signs and Symptoms of Tension Headaches
- It is experienced as a dull and aching pain.
- Patient experiences pressure or tightness across the forehead, back of the head and on the sides of the head.
- Tenderness is felt in the scalp, shoulder and neck muscles.
Serious Symptoms Requiring Immediate Medical Attention
- Sudden and severe headache.
- Headache accompanied by fever, neck stiffness, alterations in the mental status, seizures, vision changes, difficulty with speech, weakness and numbness.
- Headache occurring after head injury.
What is the Difference Between Tension Headaches and Migraines?
Tension headache is most common type of headache. Tension headache is often bilateral. Patient suffering with tension headache may continue with daily activities. Migraine headache is unilateral and associated with nausea and vomiting. Most of the patient prefers to stay in dark and quite room since headache is triggered by light and sound. Migraine headache lasts for several days. Sensory warning symptoms like flashes of lights, smell and tingling symptoms in arms or leg precedes migraine headache. Intensity of tension headache is mild to moderate unlike migraine headache, which is often severe.
Investigations for Tension Headaches
The doctor will conduct physical and neurological exam to diagnose the type of headache and its cause. The doctor will also look into the characteristics of the pain, i.e., if the pain is sharp or dull in nature? Whether it is continuous or throbbing in nature? How severe is the pain? Is it disrupting your quality of life? Is the pain bilateral or located on one side only? Is it confined to forehead or does it occur behind the eyes? All these questions are important in diagnosis of a tension headache.
Other than the physical, neurological exam and the above questions, some imaging studies are also done to rule out other serious conditions such as tumor. These imaging studies include:
- Computerized Tomography (CT) Scan: This test produces a sequence of computer-directed x-rays of the brain.
- Magnetic Resonance Imaging (MRI) Scan: This test produces images of the brain with the help of computer technology, magnetic field and radio waves.
Treatment for Tension Headaches
Tension headaches have become a common affliction today. Sadly, many people try to self-treat them at home and frequent use of over-the-counter pain killers leads to overuse headaches or rebound headaches.
Medications Which Are Available To Treat Tension Headaches Include
- Pain Killers: OTC pain killers such as ibuprofen, aspirin, naproxen; and prescription pain killers, such as indomethacin and ketorolac help in pain relief.
- Combination Drugs: A combination of aspirin or acetaminophen with a sedative drug or caffeine helps in relieving tension headaches more effectively than a single medication.
- Narcotics and Triptans: Triptans help in alleviating not only episodic tension headaches, but also migraines. Narcotics/opiates are not commonly used, as they have side effects and patients tend to become addicted to them.
Preventive Medications help in reducing the severity and frequency of headaches and they include:
- Tricyclic Antidepressants: These include nortriptyline and amitriptyline and help in preventing tension headache. Side effects include drowsiness, weight gain and mouth dryness.
- Muscle Relaxants and Anticonvulsants: Anticonvulsants such as topiramate also help in preventing tension headaches. However, research is still going on.
Lifestyle Modifications for Tension Headaches
- Resting and relaxing is important for relieving tension headaches.
- Patients should avoid taking undue stress and try to keep stress at bay by planning and organizing ahead of time.
- Heat or ice application will ease the sore muscles and help in relieving tension headaches.
- Practicing good posture also helps, as it keeps the muscles strong and helps in preventing not only tension headaches, but also various body pains.
- Alternative therapies such as acupuncture, massage, behavior therapies, deep breathing and biofeedback help in relaxing, preventing and managing tension headaches and can also be tried.