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Tension Headaches: Causes, Symptoms, Diagnosis, and Therapy
June 7th ,2023

Tension Headaches: Causes, Symptoms, Diagnosis, and Therapy

Tension headaches are also known as stress headaches. It is a pain or discomfort in the head, scalp, or neck and is often associated with muscle tightness in these areas.  

Types of tension headaches-

According to the frequency and duration of pain, tension headaches come in two forms-

Episodic Tension Headaches

Episodic headaches are further divided into two parts-

  • Infrequent episodic headaches: One or fewer episodes per month.
  • Frequent episodic headaches: More than one but fewer than 15 episodes per month, lasting 3-4 months. They are frequently brought on by stress, bad posture, or tight muscles and can last anywhere from 30 minutes to several days or months. 

Rest, over-the-counter painkillers, or relaxation methods may relieve those with episodic tension headaches.

Chronic Tension Headaches

Chronic tension headaches are distinguished by their frequency, occurring 15 or more days a month for at least three months. Although the pain is often less severe than episodic tension headaches, it can be chronic and interfere with everyday activities. Chronic tension headaches are often treated with medication, lifestyle modifications, stress management strategies, and identifying and controlling underlying causes.

Symptoms of tension headaches -

Tension headache symptoms include a dull, agonizing pain that may spread to both sides of the head. 

Other typical symptoms include –

  • Mild to moderate pain: Tension headaches typically involves a dull, aching pain that is often described as tight band around the head.
  • Tenderness of scalp, neck and shoulders: Many individuals experience tenderness and sensitivity in the muscles of this area. 
  • Head pressure or tightness: Pain and sensation of muscle tightness is often noticed. 
  • Duration: This pain may last from 15 mins or more than an hour.

Unlike migraines, tension headaches generally do not cause nausea, vomiting, or sensitivity to light and sound. However, some individuals may experience mild sensitivity to light or noise.

Causes of Tension Headaches-

  • Muscle tension: Muscle tension and spasms, stress, poor posture, and prolonged muscle contractions in the head, neck, and shoulder muscles can cause tension headaches.
  • Factors of an emotional and psychological nature: Tension headaches are mostly caused on by emotional stress, anxiety, and sadness.
  • Environmental factors: Stress headaches may be brought on by bright lights, loud noises, strong scents, and changes in the weather.
  • Lifestyle choices: Poor food, dehydration, excessive coffee use, irregular sleeping pattern, and a lack of physical exercise can all lead to tension headaches.
  • Jaw clenching / Teeth grinding: Habitual teeth grinding can strain muscles

Tension Headache Diagnosis-

Medical experts often use the patient's medical history, a thorough description of their symptoms (including pain intensity, location, and frequency), and a physical examination to diagnose tension headaches. 

Examinations such as blood tests, CT scan /MRI (these tests are usually not necessary)

Treatment for Tension Headaches-

The treatment of tension headache focuses on reducing pain and the frequency or severity of future episodes. The following treatment can be done depending on the condition and the severity of pain:

  • Nonsteroidal anti-inflammatory

Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen or acetaminophen, can help reduce mild to moderate tension headache discomfort. 

  • Relaxation techniques

Exercises like progressive muscle relaxation, yoga, meditation, and deep breathing can help lower stress and loosen tense muscles.

  • Physical treatment

Methods that help relieve muscle tension and enhance posture include massage, heat or cold therapy, and light stretching exercises.

  • Tension headache management

Tension headache management may benefit from identifying and resolving sources of stress using strategies like counseling, cognitive-behavioral therapy (CBT), or stress reduction programs.

  • Medicine

In certain circumstances, doctors may recommend drugs such as muscle relaxants, tricyclic antidepressants, or anticonvulsants if persistent tension headaches or severely interfere with everyday living.

It is crucial to remember that a medical practitioner must closely monitor prolonged pharmaceutical usage.

Prevention tips to avoid a tension headache- 

The following are some methods to prevent stress headaches-

  • Stress management: Find techniques for relaxing and coping with stress, such as:
    • Biofeedback
    • Behavioural and cognitive treatment
  • Regular physical activity: Exercise often to ease stress and relax the muscles. On most days of the week, try to get in at least 30 minutes of moderate activity.
  • Adequate rest and sleep: Make sure you receive good rest and sleep on a regular schedule. Create a comfortable sleeping environment and establish a calm nighttime ritual.
  • Relaxation methods: Use relaxation techniques such as progressive muscle relaxation, guided visualization, or deep breathing exercises to assist in the release of muscular tension and promote peace.
  • Avoid triggers: Recognize and stay away from situations that often cause you to have tension headaches. These could include particular foods and drinks, bright lights, loud noises, and strong odors.
  • Drink plenty of water: Ensure you get enough water because dehydration can lead to headaches.
  • Take regular pauses to stretch and walk about: if you have a sedentary job or spend much time in front of a computer. To release stress, gently extend your upper back, shoulders, and neck.
  • Healthy living practices: include eating a balanced diet, cutting back on processed foods and sugary snacks, and avoiding drinking too much alcohol or caffeine.

Adopting good habits and making specific lifestyle changes are necessary to prevent tension headaches. 

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