What is a tension headache?
According to the International Headache Society they involve any two of the following: pressing or tightening; pain in front or both sides of the head; mild or moderate pain; pain that is not made worse by physical activity
What are the symptoms?
They can last from half an hour to a week. The pain is usually described as a band or tightening across the forehead or squeezing on each side of the temples. It is a dull and constant. Unlike migraine there is no aura, vomiting or visual problem. But it may be uncomfortable to be in the light and your scalp and neck muscles may be tender when you wake up. If you get 15 or more a month, for at least three months, you have chronic tension headaches.
What causes it?
No one knows. Chemicals in the brain might be altered in people with tension headaches – so stopping the brain being able to suppress pain.
What triggers it?
Stress, lack of sleep, anxiety and poor posture can all cause them. Sunshine, when it is very bright, and some foods may be triggers. Some people get them if they get tired or hungry or strain to read in poor light. If you regularly use painkillers for headaches you can get rebound headaches when you stop.
How can I treat it?
Keep a headache diary to find your triggers. It should be simple to eat and sleep properly, but of course it isn't. Lie down in a quiet room when a headache comes on. Deep breathing or meditation can help, as can exercise. Paracetamol should work, as do non-steroidal anti-inflammatory drugs such as ibuprofen, but they irritate the stomach more. Avoid painkillers with codeine – they increase the risk of rebound headaches. Don't take painkillers for more than a few days at a time. Medication such as amitriptyline can help chronic tension headaches.
When should I see my doctor?
If you have a headache that doesn't fit the criteria, or if your headaches have changed or started in middle age, or if you have other symptoms such as a fever, or problems moving or with the sensation of any part of your body.
