Tension-type headachesOverview

A tension-type headache is the most common type of headache and the one we think of as a normal everyday headache.

It may feel like a constant ache that affects both sides of the head. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes.

A tension headache normally won't be severe enough to prevent you doing everyday activities.

It usually lasts for 30 minutes to several hours, but can last for several days.

Who gets tension headaches?

Most people are likely to have experienced a tension headache at some point.

They can develop at any age, but are more common in teenagers and adults.

Women tend to suffer from them more commonly than men.

Some adults experience tension-type headaches more than 15 times a month for at least 3 months in a row.

This is known as having chronic tension-type headaches.

When to seek medical help

There's usually no need to see your GP if you only get occasional headaches.

But see your GP if you get headaches several times a week or they're severe.

Your GP will ask questions about your headaches, family history, diet and lifestyle to help diagnose the type of headache you have.

You should seek immediate medical advice for headaches that:

• come on suddenly and are unlike anything you have had before
• are accompanied by a very stiff neck, fever, nausea, vomiting and confusion
• follow an accident, especially if it involved a blow to your head
• are accompanied by weakness, numbness, slurred speech or confusion

These symptoms suggest there could be a more serious problem, which may require further investigation and emergency treatment.

What causes tension headaches?

The exact cause of tension-type headaches isn't clear, but certain things have been known to trigger them.

These include:

• stress and anxiety
• squinting
• poor posture
• tiredness
• dehydration
• missing meals
• lack of physical activity
• bright sunlight
• noise
• certain smells

Tension-type headaches are known as primary headaches, which means they're not caused by an underlying condition. 

Other primary headaches include cluster headaches and migraines.

How are tension headaches treated?

Tension-type headaches aren't life threatening and are usually relieved by painkillers or lifestyle changes.

Lifestyle changes

Relaxation techniques can often help with stress-related headaches.

This may include:

• yoga
• massage
• exercise
• applying a cool flannel to your forehead or a warm flannel to the back of your neck

Read more about relaxation tips to help with stress.

Painkillers

Painkillers such as paracetamol or ibuprofen can be used to help relieve pain. Aspirin may also sometimes be recommended.

If you're taking these medications, you should always follow the instructions on the packet.

Pregnant women are advised to avoid ibuprofen and shouldn't take ibuprofen from 30 weeks of pregnancy onwards, as it could risk harming the baby.

Children under 16 shouldn't be given aspirin.

Medication shouldn't be taken for more than a few days at a time.

Medication containing codeine, such as co-codamol, should be avoided unless recommended by a GP.

Painkiller headaches

Taking painkillers over a long period (usually 10 days or more) may lead to medication-overuse headaches developing.

Your body can get used to the medication and a headache can develop if you stop taking them. 

If your GP suspects your headache is caused by the persistent use of medication, they may ask you to stop taking it.

But you shouldn't stop taking your medication without first consulting your GP.

Preventing tension headaches

If you experience frequent tension-type headaches, you may wish to keep a diary to try to identify what could be triggering them.

It may then be possible to alter your diet or lifestyle to prevent them occurring as often.

Regular exercise and relaxation are also important measures to help reduce stress and tension that may be causing headaches.

Maintaining good posture and ensuring you're well rested and hydrated can also help.

Guidelines from the National Institute for Health and Care Excellence (NICE) state that a course of up to 10 sessions of acupuncture over a 5- to 8-week period may be beneficial in preventing chronic tension-type headaches.

In some cases, an antidepressant medication called amitriptyline may be prescribed to help prevent chronic tension-type headaches, although there's limited evidence of its effectiveness.

This medication doesn't treat a headache instantly, but must be taken daily for several months until the headaches lessen.