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Tension Headache


Tension headaches are most often caused by stress, eye strain, or muscle tightness. The pain of a tension headache may start in the forehead or the back of the head. The pain often spreads over the whole head and down into the neck and shoulders. Over-the-counter pain medicine is the most useful and common treatment for a tension headache. Exercise, biofeedback, meditation, or relaxation techniques may also decrease your headache pain.



  • NSAIDs: These medicines decrease pain. You can buy NSAIDs without a doctor's order. Ask your primary healthcare provider which medicine is right for you and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.

  • Acetaminophen: This medicine decreases pain. You can buy acetaminophen without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

  • Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

Manage your symptoms:

  • Keep a headache diary: Keep a record of your headaches. Include when they start and stop and what made them better. Describe your symptoms, such as how the pain feels, where it is, and how bad it is. Record anything you ate or drank for the past 24 hours before your headache. Bring this to follow-up visits.

  • Heat: Heat may help decrease headache pain and muscle spasms. Apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed.

  • Ice: Ice may help decrease headache pain. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel and place it on the area for 15 to 20 minutes every hour as directed.

Prevent tension headaches:

  • Prevent muscle tension: Do not stay in one position for long periods of time. This includes reading, sewing, or working at a computer. If you wake up with sore neck and shoulder muscles, use a different pillow. Find ways to relax your muscles, such as massage or resting in a quiet, dark room.

  • Avoid eye strain: Make sure you have good lighting when you read or perform tasks. Have yearly eye exams, and wear glasses if you need them.

  • Eat a variety of healthy foods: Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Eat regular meals. Use your headache diary to track any foods that cause a headache. Ask if you need to be on a special diet.

  • Exercise: This may help to decrease stress and headaches. Ask about the best exercise plan for you.

  • Do not drink alcohol or overuse over-the-counter or prescription medicines: Alcohol can cause sleep problems, depressed feelings, and increased stress. This can cause tension headaches to start or make them worse.

  • Do not smoke: This can trigger a headache. If you smoke, it is never too late to quit. Ask for information if you need help quitting.

Contact your primary healthcare provider if:

  • Your headaches continue to get worse.

  • Your headaches happen so often that they affect your ability to do your work or normal activities.

  • You need to take medicine to help your headaches more often than your primary healthcare provider says you should.

  • Your headaches get so bad that they cause you to vomit.

  • You have questions or concerns about your condition or care.

Return to the emergency department if:

  • You have a sudden headache that seems different or much worse than your usual headaches.

  • You have difficulty seeing, speaking, or moving.

  • You pass out, become confused, or have a seizure.

  • You have a headache, fever, and a stiff neck.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.