Tension Headaches

Signs and Symptoms

Tension-type headache is a term used to describe chronic headaches that cause a tight, band-like pain. This is the most common type of headache, afflicting 88 percent of women and 68 percent of men. A tension headache is a mild to moderate steady pain, tightness or pressure around the head and neck. These headaches may be provoked by the stress and frustrations of everyday life, eyestrain or poor posture.

When tension-type headaches occur on a daily or almost daily basis, they are called chronic daily headaches. Often, other symptoms accompany these headaches including fatigue, sleep disturbances and depression. Tension-type and migraine headaches can and often do occur together, and many doctors believe that the two types of headaches arise from the same mechanism.

Diagnosis

Tension-type headaches usually are diagnosed by the symptoms you describe to your doctor. Your doctor will ask you about the severity, frequency and duration of your headaches as well as other symptoms that occur and any medications you are taking. Keeping a headache journal is a great way to track the location and severity of the pain, the duration of the pain, any medications taken and any possible headache triggers.

If your doctor suspects a tumor or aneurysm, you may undergo one or more of the following tests:

• Computerized Tomography (CT) Scan -- A CT scan uses a thin X-ray beam that rotates around the area being examined. A computer processes data to construct a three-dimensional, cross-sectional image.

• Magnetic Resonance Imaging (MRI) -- An MRI uses magnetism, radio waves and computer technology, rather than X-rays, to produce images of your brain.

Treatment

Your doctor may prescribe drugs to prevent as well as to treat tension-type headaches.

Drugs that may help prevent tension headaches include:

• Tricyclic Antidepressants -- Antidepressant drugs have analgesic or pain-relief qualities. Although you may not be depressed, your doctor may prescribe drugs such as amitriptyline or doxepin to help reduce the frequency and severity of your headaches.

• Beta-blockers -- A drug such as propranolol may be combined with an antidepressant, such as amitriptyline, to prevent chronic daily headaches.

• Divalproex Sodium -- This drug is used to treat chronic daily headache, including chronic tension-type headaches.

Drugs prescribed to treat the pain of tension headaches include:

• Nonprescription Pain Relievers -- These are usually adequate to relieve mild to moderate pain. They include aspirin, acetaminophen, ibuprofen and naproxen.

• Combination Pain Relievers -- The use of these drugs is limited, because overuse can worsen the headache pattern and over time can become habit forming. These drugs often contain butalbital, a barbiturate, or narcotics combined with aspirin or acetaminophen.

If your doctor prescribes medication, be sure to ask for the following information:

• How often the medication should be taken
• If the medication should be taken with meals or on an empty stomach
• What to do if pain or other symptoms persist

Your doctor may schedule follow-up visits to determine if the treatment is effective.