An in-depth report on the causes, diagnosis, treatment, and prevention of common headaches.
What Are Tension-Type Headaches?
Tension-type headaches are the most common type of headache, accounting for about half of all headaches. The pain is usually mild-to-moderate in intensity, with a steady pressing or tightening quality (like a vise being squeezed around the head). The headache is not accompanied by nausea or vomiting, and the pain is not increased by routine physical activity such as walking or climbing stairs. A tension-type headache attack can last anywhere from 30 minutes to an entire week.
Who Gets Tension-Type Headaches?
Women are more likely to get tension-type headaches than men. Nearly everyone will have at least one tension-type headache at some point in their lives and more than a third of people will experience a tension headache each year. Many people who have migraine headaches also have tension-type headaches.
What Is The Difference Between Tension-Type Headaches and Migraine Headaches?
Migraines and tension headaches have some similar characteristics, but also some important differences:
- Migraine pain is usually throbbing while tension-type headache pain is usually a steady ache.
- Migraine pain often affects only one side of the head while tension-type headache pain typically affects both sides of the head.
- Migraine headaches, but not tension-type headaches, may be accompanied by nausea or vomiting, sensitivity to both light and sound.
- Tension headaches don't typically have a warning or aura.
Treatment of tension-type headache focuses on relieving pain when attacks occur, and preventing recurrence of attacks. Most tension-type headache attacks respond to simple nonprescription pain relievers such as aspirin, ibuprofen (Advil, Motrin, generic), or naproxen (Aleve, generic). However, these medications, especially those that contain caffeine, should not be used more than twice a week because they can cause medication overuse (rebound) headaches.
People who have two or more tension-type headache attacks each month should talk to their health care providers about preventive therapy. This may include a tricyclic antidepressant, such as amitriptyline (Elavil, generic), combined with behavioral therapies. Behavioral treatment approaches include relaxation therapy, biofeedback, stress management, and cognitive-behavioral therapy.