Introduction:
Tension headaches are very common, affecting up to 78% of the general population. Unfortunately, they're also among the most neglected and difficult types of headaches to treat. Pain is caused by tightness (contraction) of your neck, and scalp muscles. With a tension headache, the pain often starts at the back of your head and moves forward, so that it eventually includes your neck, scalp, and head. It' s often described as feeling like you have a tight band across your head. It may be caused by staying in one position for a long time, such as in reading, using a computer, or playing video games. It may be also caused by stress, but sometimes there is no obvious cause. If your headaches happen 15 or more days in a month for several months, they are considered chronic tension headaches.
Signs and Symptoms:
Causes:
Researchers aren't clear on exactly what causes a tension headache. For years, scientists thought that it was caused by tightening the muscles in your shoulders, neck, scalp, and jaw when you are tense. But new tests that measure muscle tension have shown that the muscles of people with tension headaches aren' t any tighter. Newer theories suggest tension headaches are caused by changes in brain chemicals(neurotransmitters, including serotonin), similar to what happens with a migraine. Scientists don' t know why the levels of neurotransmitters go up and down, but they think it activates pain pathways in the brain. Tight muscles may help trigger the changes in neurotransmitters, or muscle tightness may be a result of fluctuating levels of brain chemicals.
Triggers may include:
Diagnosis:
Your doctor will take a detailed history in order to distinguish tension headaches from headaches of other causes, such as migraines. He or she will ask questions about when your headaches occur, how long they last, how frequently they come on, the location of the pain, and any symptoms that accompany theheadaches. Sometimes it helps to keep a diary about your headaches before seeing the doctor; so you have an accurate recording of how often they happen.
Your doctor will examine your head, neck, eyes, and sinuses and do a neurologic examination. Don't be surprised if the doctor asks you some questions to test your short term memory. On exam, the physician is likely to find musculoskeletal tenderness around your neck and scalp.
If you have unusual symptoms, your doctor may order these tests:
Treatment Approach:
A comprehensive treatment plan including relaxation (see Mind/Body Medicine), exercise and other lifestyle changes, and occasional medication can be very effective in reducing the frequency and intensity of tensionheadaches.
Biofeedback, yoga, and relaxation techniques, for example, can help relieve pain and lower the number ofheadaches you have. Regular exercise helps, too. One study found that an ancient medical technique called wet-cupping reduced headache severity by 66%. Patients also experienced about 12 fewer days ofheadaches
Tension headaches are very common, affecting up to 78% of the general population. Unfortunately, they're also among the most neglected and difficult types of headaches to treat. Pain is caused by tightness (contraction) of your neck, and scalp muscles. With a tension headache, the pain often starts at the back of your head and moves forward, so that it eventually includes your neck, scalp, and head. It' s often described as feeling like you have a tight band across your head. It may be caused by staying in one position for a long time, such as in reading, using a computer, or playing video games. It may be also caused by stress, but sometimes there is no obvious cause. If your headaches happen 15 or more days in a month for several months, they are considered chronic tension headaches.
Signs and Symptoms:
- Headache starts at the back of your head and spreads forward
- Dull pressure or a squeezing pain, often described as a tight band around the head
- Muscles in your neck, shoulders, and jaw can feel tight and sore
- Affects both sides of your head equally
- May have difficulty sleeping or eating
Causes:
Researchers aren't clear on exactly what causes a tension headache. For years, scientists thought that it was caused by tightening the muscles in your shoulders, neck, scalp, and jaw when you are tense. But new tests that measure muscle tension have shown that the muscles of people with tension headaches aren' t any tighter. Newer theories suggest tension headaches are caused by changes in brain chemicals(neurotransmitters, including serotonin), similar to what happens with a migraine. Scientists don' t know why the levels of neurotransmitters go up and down, but they think it activates pain pathways in the brain. Tight muscles may help trigger the changes in neurotransmitters, or muscle tightness may be a result of fluctuating levels of brain chemicals.
Triggers may include:
- Stress
- Depression
- Anxiety
- Holding your head in one position for a long time (like using a computer)
- Sleeping in an awkward position or in a cold room
- Eye strain
- Fatigue
- Overexertion
- Skipping meals
- Head or neck injury, even years after the injury
- Clenching your jaw or grinding your teeth (bruxism)
- Medications, including some headache medications (leading to rebound headaches)
- Arthritis
- Gender – women tend to have more headaches than men
- Changes in estrogen levels (during a woman' s period or at menopause)
- Premenstrual syndrome
- Stress
- Chronic overwork
- Too much or too little sleep
- Missing meals
- Alcohol or drug use
Diagnosis:
Your doctor will take a detailed history in order to distinguish tension headaches from headaches of other causes, such as migraines. He or she will ask questions about when your headaches occur, how long they last, how frequently they come on, the location of the pain, and any symptoms that accompany theheadaches. Sometimes it helps to keep a diary about your headaches before seeing the doctor; so you have an accurate recording of how often they happen.
Your doctor will examine your head, neck, eyes, and sinuses and do a neurologic examination. Don't be surprised if the doctor asks you some questions to test your short term memory. On exam, the physician is likely to find musculoskeletal tenderness around your neck and scalp.
If you have unusual symptoms, your doctor may order these tests:
- Computed tomography (CT) scan or magnetic resonance imaging (MRI), to rule out a tumor or aneurysm, or to check for sinusitis
- X-ray of the neck to look for arthritis or spinal problems; x-ray of the sinuses to look for sinusitis
- Electroencephalogram (EEG), a brain wave study, to look for any seizure activity
Treatment Approach:
A comprehensive treatment plan including relaxation (see Mind/Body Medicine), exercise and other lifestyle changes, and occasional medication can be very effective in reducing the frequency and intensity of tensionheadaches.
Biofeedback, yoga, and relaxation techniques, for example, can help relieve pain and lower the number ofheadaches you have. Regular exercise helps, too. One study found that an ancient medical technique called wet-cupping reduced headache severity by 66%. Patients also experienced about 12 fewer days ofheadaches
