Tension Headache

What causes a tension headache?

Tension headaches are often caused by tense muscles in your head or neck and can last anywhere from 30 minutes to several days. Although they are uncomfortable, tension headaches usually do not cause any serious problems. The following can cause muscle tension and trigger a tension headache:

  • Eye strain or poor posture

  • Jaw or dental problems such as temporomandibular joint (TMJ), clenching your jaw, or grinding your teeth

  • Activities that cause your head to be held in one position for too long

  • Skipping a meal

  • Not enough sleep or sleep apnea (brief periods of not breathing during sleep)

  • Food sensitivities, such as to gluten

What are the symptoms of a tension headache?

  • Dull, constant pain above your eyes and across the back of your head

  • Head pain that gets worse as the day goes on

  • Pain that may spread over your entire head and to your neck and shoulders

  • Tight neck or shoulder muscles

  • Head pain that is made worse by bright lights or loud noises

How are tension headaches diagnosed?

Your caregiver will examine you and ask about other health conditions you have or medicine you take.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your head. These help caregivers see the tissue and blood vessels in your head. You may be given a dye before the pictures are taken to help the pictures better show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your head. It shows the tissue and blood vessels in your head. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.

How are tension headaches treated?

  • Medicines:

    • NSAIDs: These medicines decrease pain. You can buy NSAIDs without a doctor's order. Ask your caregiver 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.

  • Other treatments: You may need to see caregivers that specialize in back, muscle, or posture problems. Other caregivers may help you with jaw or teeth problems. The treatments you need depend on what is causing your headaches. Ask your caregiver about other treatments you may need to help your headaches.

How can I manage my symptoms?

  • 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.

How are tension headaches prevented?

  • Avoid 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 decrease stress and headaches. Ask your caregiver 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 your caregiver for information if you need help quitting.

When should I contact my caregiver?

Contact your caregiver 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 caregiver says you should.

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

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

When should I seek immediate care?

Seek care immediately or call 911 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.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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