Tension Headaches: Causes, Symptoms and Ways to Find Relief
Tension headaches are extremely common, but that doesn't make them any less frustrating.
You may notice a dull ache developing across your forehead, pressure around your head or discomfort extending into your neck. Sometimes it feels as though a tight band has been placed around your head.
For some people, tension headaches are occasional. For others, they keep returning and begin to interfere with everyday life.
Stress, sleep problems and caffeine can all play a part, and relaxation may help some people. But headaches can have many different causes, so it is also important not to assume that every headache is simply caused by tension.
What Does a Tension Headache Feel Like?
A typical tension-type headache usually causes pain on both sides of the head, face or neck.
Rather than the throbbing or pulsating pain often associated with migraine, it tends to feel like pressure or tightening. The affected area may also feel tender to touch.
Tension headaches can last from around 30 minutes to several days. Although uncomfortable, they don't usually become worse with ordinary daily activities.
You might describe the feeling as:
pressure around your forehead
a tight band around your head
an ache on both sides of your head
tenderness around your scalp
discomfort extending into your face or neck
If your headaches don't fit this pattern, don't simply assume they're tension headaches.
What Causes Tension Headaches?
There isn't always one obvious cause.
The NHS lists stress, sleep problems and caffeine among common factors associated with tension headaches.
For some people, several things may be happening at once.
You might be going through a stressful period, sleeping badly and drinking more coffee than usual to compensate for feeling tired.
It can therefore be useful to look at what is happening in your life around the time your headaches appear rather than searching for one single explanation.
Is Stress Causing Your Headaches?
Stress and headaches can become closely connected.
You may notice headaches appearing during particularly demanding periods at work, when you're worrying about something or after spending hours feeling tense.
You might also become aware that when you're stressed you tighten your jaw, raise your shoulders or hold tension around your neck without realising it.
The difficulty is that this can become a cycle.
Stress → physical tension → headache → worry about the headache → more tension
Finding ways to reduce stress and relax doesn't guarantee that a headache will disappear, but if stress is one of your triggers, learning to respond differently to it may be useful.
Could Your Sleep Be Playing a Part?
Sleep problems are another recognised trigger for tension headaches.
If your headaches have become more frequent, think about whether anything has changed in your sleeping pattern.
Are you going to bed much later?
Are you waking frequently?
Are you lying awake worrying?
Do you regularly wake feeling as though you haven't rested properly?
Improving sleep won't necessarily resolve every headache, but if poor sleep and headaches started around the same time, it is certainly worth considering the connection.
What About Caffeine?
Caffeine can also be associated with tension headaches, and the NHS suggests reducing caffeinated drinks if they appear to be contributing.
Think about how much tea, coffee, cola or other caffeinated drinks you consume throughout the day.
Also remember that suddenly changing a well-established caffeine habit can itself sometimes be associated with headaches, so if you consume large amounts and want to reduce your intake, you may prefer to make changes gradually.
Keep a Headache Diary
If you're getting recurring headaches and aren't sure why, a headache diary can be surprisingly useful.
Record:
when the headache started
how long it lasted
where you felt the pain
how severe it was
any other symptoms
what you had been doing beforehand
how you had slept
anything you think might have triggered it
any medication you took
NICE recommends headache diaries as a useful part of assessing recurring headaches.
After a few weeks, you may begin to see a pattern that wasn't obvious before.
The diary can also provide useful information if you decide to discuss your headaches with your GP.
How Can You Relieve a Tension Headache?
If you recognise the symptoms of a tension headache and there are no concerning symptoms, there are several simple measures that may help.
The NHS suggests relaxation activities such as exercise, yoga and massage. If neck discomfort accompanies the headache, a low, firm pillow and heat or cold packs may also be worth trying.
You might also find it helpful to:
step away from your computer or phone for a while
deliberately relax your shoulders and jaw
take a gentle walk
rest somewhere quiet
look at whether stress or poor sleep has increased recently
You don't need to try everything at once.
If your headaches recur, identifying what seems to help you can be more useful than constantly trying different remedies.
What About Painkillers?
Painkillers such as paracetamol, aspirin or anti-inflammatory medicines may be used for tension-type headaches, depending on what is suitable for the individual. NICE advises taking account of other health conditions and possible side effects, and aspirin should not be given to anyone under 16.
If you're unsure which medicine is suitable for you, ask a pharmacist or healthcare professional.
There is also an important reason not to rely too heavily on painkillers.
Taking headache medication too frequently can itself contribute to medication-overuse headaches.
If you find yourself regularly reaching for painkillers because headaches keep returning, speak to your GP rather than simply continuing to increase how often you take them.
Relaxing the Body When You Feel Tense
When you've been concentrating or worrying for a long time, you may not notice how much physical tension you're holding.
Try this simple check.
Notice your forehead.
Then your jaw.
Your shoulders.
Your hands.
Are you tightening anything unnecessarily?
Don't force the muscles to relax. Simply allow yourself to release some of that effort.
Take a few slower, comfortable breaths and let your shoulders settle.
This isn't a treatment for every headache. But if you recognise that stress and physical tension tend to occur together for you, regularly noticing and releasing unnecessary tension may be a useful habit.
Can Self-Hypnosis Help with Tension Headaches?
Because stress and relaxation can be relevant to tension headaches, some people choose to use self-hypnosis as part of their approach to relaxation and tension management.
Self-hypnosis involves entering a deeply relaxed, focused state while listening to carefully constructed suggestions.
Sharon Shinwell, the UK clinical hypnotherapist behind Self Hypnosis UK, has more than 25 years' professional experience in hypnotherapy, counselling and psychotherapy.
Her Overcoming Tension Headaches Self-Hypnosis MP3 has been created to encourage deep relaxation, help the listener become more aware of unnecessary physical tension and develop a calmer response to everyday stress.
It is important to be clear about what this means.
Self-hypnosis should not be used to assume that an unexplained or recurring headache is caused by stress, nor should it replace appropriate medical advice or treatment.
It is better thought of as a relaxation-based approach that may be particularly relevant when you already recognise stress and tension as part of your headache pattern.
When Should You See Your GP About Headaches?
Speak to your GP if you're getting headaches several times a week, they're severe, or self-care and appropriate pain relief aren't helping.
You should also seek medical advice if the nature of your headaches changes substantially or you develop symptoms that don't fit your usual pattern.
For example, migraine often has different characteristics from a typical tension headache and may involve throbbing pain, nausea or increased sensitivity to light or sound.
Getting the correct diagnosis matters, particularly when headaches are frequent or changing.
When Does a Headache Need Urgent Medical Attention?
Most headaches aren't caused by something serious, but there are circumstances where urgent medical assessment is important.
Seek urgent medical help if a severe headache is accompanied by concerning symptoms such as weakness or numbness, problems with vision, confusion, problems speaking or remembering, or certain other neurological symptoms.
A headache that begins suddenly and is extremely painful also requires emergency medical attention.
If you're unsure about new or unusual headache symptoms, seek appropriate medical advice rather than assuming they're caused by tension.
Reducing the Chances of Tension Headaches Returning
If your tension headaches have identifiable triggers, prevention may be as important as dealing with the headache once it arrives.
Look back at your headache diary.
Is stress the recurring factor?
Poor sleep?
Caffeine?
Long periods when you barely move or relax?
You may discover that several small changes are more useful than searching for one dramatic solution.
That could mean introducing regular breaks during the working day, improving your sleep routine, reducing caffeine if appropriate or deliberately making time for activities that help you relax.
Most importantly, pay attention to the patterns your own body is showing you.
Learning to Recognise Your Own Headache Pattern
Tension headaches are common, but recurring headaches shouldn't simply become something you put up with indefinitely.
Start by noticing when they happen and what else is going on at the time.
Look at stress, sleep and caffeine.
Experiment with appropriate relaxation and self-care.
Keep a headache diary if the pattern isn't clear.
And seek medical advice when headaches are frequent, severe, changing or accompanied by unusual symptoms.
If stress and physical tension are clearly part of your own pattern and you would like an additional way to work on relaxation, you can find out more about Sharon Shinwell's Overcoming Tension Headaches Self-Hypnosis MP3 here.
