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Tension Headaches

Tension headache is caused by a tightening of the muscles of the neck and shoulders, and is the most common of all headache types. The muscle tension extends up the neck up to the base of the skull, and may spread to different parts of the head. It is usually described as a dull, contractive pain that may become vice-like, with tightness or pressure across the forehead or back of the head and neck.

Tension-type headaches account for 90% of all headaches, with the incidence twice as high in women compared to men. They can occur periodically or daily, and can last anywhere from 30 minutes to several days. Some people have a headache for 2 to 3 months at a time. Tension headaches usually begin gradually, and often occur in the middle of the day. A high proportion are stress related. The severity of a tension headache tends to increase with its frequency.

Causes of tension headache include:

  • Stress, anxiety, depression
  • Tiredness, insufficient rest
  • Hunger (low blood sugar)
  • Poor posture
  • Physical exertion

A stressful incident can trigger a headache. Ongoing stress can contribute to chronic tension headaches. These can include work or relationship stresses, over-commitment with too many activities, lack of work-life balance and chronic sleep issues.

Symptoms can include some or all of the following:

  • Pain, tightness and/or pressure in the front, top or sides or back of the head
  • Tension and stiffness in the neck muscles
  • Headache comes on later in the day
  • Sleep issues – difficulty going to sleep or staying asleep
  • Fatigue
  • Irritability
  • Hard to concentrate

Tension headache does not have the preceding aura with visual disturbances, nausea or light sensitivity found in migraine headaches.


  • Ice packs on the back of the neck and/or forehead can help relieve congestion and head/neck pain.
  • When you don’t have a headache, heat packs are effective in relaxing muscle tension and increasing blood flow to the area. These should always be covered with a layer of towel.
  • Pain medication may be needed to relieve the headache. However natural medicines can help you deal with the underlying cause of tension headaches, lessening their frequency and severity.
  • Magnesium is a nutritional muscle relaxant that has been proven effective in reducing stress and muscle tension. This is available in tablet or powder form.
  • For chronic persistent pain, a TENS unit can provide a viable alternative to having to continually take pain medication.
  • Chiropractic or osteopathic treatments can offer an effective approach for tension headaches by relieving neck muscle tension and releasing pressure in the spine and base of skull.
  • Massage can be helpful in many cases. Using a hand held massager regularly can provide relief for chronically tight neck and shoulder muscles.
  • Sleeping on a contour pillow at night and using neck support pillows while travelling can help to maintain the proper alignment of your neck.
  • Neck stretches can help alleviate tension in your neck muscles. Stretches are particularly effective after using heat. Regular stretch breaks at your computer can help prevent spinal compression and muscle fatigue.
  • Proper workstation ergonomics and correct head and neck posture are important to avoid continual strain on the muscles and spine.
  • Exercises and stretches while at work are helpful, especially at a desk job.
  • Attention to overall work / life balance, stress levels, sleep and regular meals can help prevent tension-type headaches.