Tension Headaches

Tension-type headache is a term used to describe a headache causing mild to moderate pain that often feels like a tight band across your forehead or pressure around the head and neck. These headaches may be provoked by the stress of everyday life, eyestrain or poor posture. They are not worsened by routine activity, and therefore usually don't prevent people from going about their daily activities.

Typically, the pain is not troublesome enough to cause sufferers to see a doctor. People who get tension-type headache do not experience sensitivity to light, sound, or movement, and they do not experience nausea or vomiting.

The underlying cause of tension-type headache is unknown.

Symptoms of a tension headache include:

  • Mild to moderately intense pain, lasting from 30 minutes to as long as an entire week
  • Tightness or pressure across your forehead or on the sides and back of your head
  • Tenderness on your scalp, neck and shoulders
  • Sometimes, loss of appetite

Tension headaches are considered chronic if they occur 15 or more days a month for at least three months. They're considered epidsodic if they occur fewer than 15 times a month.

Tension headaches differ from migraines in that they're not associated with abdominal pain, nausea and vomiting, slurred speech, visual disturbances such as blind spots or flashing lights, and weakness or numbness on one side of the body. Physical activity typically doesn't aggravate the pain like it does migraines. Increased sensitivity to light or sound can occur, although it's not common.

Tension-type headaches usually are diagnosed based on symptoms. Your doctor will ask about the severity, frequency and duration of your headaches as well as other symptoms that occur and medications you are taking. Keeping a headache journal is a good way to track the location and severity of pain, duration of pain, medications taken and 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 create a 3-D, 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. Under the right circumstances, MRI and other imaging procedures allow doctors to see how larger structures in the brain are involved during migraine and headache.

Your doctor may prescribe drugs to prevent and treat tension 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.

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Reviewed by health care specialists at UCSF Medical Center.

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UCSF Clinics & Centers

Neurology and Neurosurgery

Headache Center
2330 Post St., Sixth Floor
San Francisco, CA 94115
Phone: (415) 353-8393
Fax: (415) 353-9539
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