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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 is a tension headache diagnosed?

Your healthcare provider will examine you and ask about other health conditions you have or medicine you take. You may need a CT or MRI scan to check the blood vessels and tissues in your head. You may be given contrast liquid to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is a tension headache treated?

  • NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Acetaminophen decreases pain. Acetaminophen is available 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.
  • Treatment may be given for back, muscle, or posture problems. You may also need treatment for jaw or tooth problems.

How can I manage my symptoms?

  • Keep a headache record. 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.
  • Apply heat as directed. 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.
  • Apply ice as directed. 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.

What can I do to prevent a tension headache?

  • Avoid muscle tension. Do not stay in one position for long periods of time. Use a different pillow if you wake up with sore neck and shoulder muscles. 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, sew, or do similar activities. Get yearly eye exams and wear glasses as directed.
  • Eat a variety of healthy foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Do not eat foods that trigger your headaches.
  • Exercise regularly. Exercise helps decrease stress and headaches. Ask about the best exercise plan for you.
  • Do not drink alcohol. Alcohol can trigger a headache. It can also prevent medicines from being able to stop your headache.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can trigger a headache and also cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

When should I seek immediate care?

  • 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.

When should I contact my healthcare provider?

  • 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 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.

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.

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