Merck Manual

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Tension Headaches


The Manual's Editorial Staff

Last full review/revision Aug 2019
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What are tension headaches?

A tension headache is a particular kind of headache that feels like a band tightening around your head.

  • Tension headaches are common and not dangerous

  • The pain isn't usually severe

  • Taking over-the-counter pain relievers, like acetaminophen or ibuprofen, helps lower your pain

  • Jaw problems, neck pain, or eyestrain can cause tension headaches

  • Stress may cause tension headaches

What causes tension headaches?

Doctors don’t understand exactly why tension headaches happen, but you may get them if you have:

  • Pain in other parts of your head and neck

  • Problems with sleep

  • Lots of stress

  • Problems with your jaw (such as temporomandibular joint disorder)

  • Eye strain—for example, from spending lots of time looking at a computer screen

What are the symptoms of tension headaches?

You have:

  • Pain in your head that feels like a band tightening around your head

  • Pain that is mild or moderate, not severe—the pain doesn’t usually stop you from your daily tasks

Tension headaches are different from migraines. With a tension headache:

  • Your pain doesn’t get worse with light, sounds, smells, or when you move around

  • Your headache doesn’t make you feel sick or throw up

There are 2 types of tension headaches, based on how often they happen:

  • Episodic headaches happen less than 15 days a month

  • Chronic (long-lasting) headaches happen 15 or more days a month

If you have episodic tension- headaches, your headache may:

  • Start several hours after waking up and get worse later in the day

  • Last 30 minutes to several days

If you have chronic tension headaches, your headache may:

  • Be almost always present, and get better and worse throughout the day

  • Get worse each day

How can doctors tell if I have tension headaches?

  • Doctors suspect tension headaches based on your symptoms and an exam

  • They’ll ask you questions about what causes your headaches

  • Doctors may do other tests, such as an MRI of your head, to make sure another health problem isn’t causing your headaches

Certain warning signs suggest your headache is not an ordinary tension headache. See a doctor right away for a headache if you have:

  • Changes in your vision, weakness, drowsiness, confusion, loss of balance, or trouble speaking

  • A fever and stiff neck

  • A sudden, very severe headache that came on like a thunderclap

  • Tenderness at your temple (as when combing hair) or jaw pain when chewing

  • Cancer, AIDS, or a weak immune system

  • A worsening headache

  • Red eyes and halos seen around lights

How do doctors treat tension headaches?

Doctors may tell you to:

  • Take pain medicine, such as aspirin, acetaminophen, or ibuprofen

  • Massage your head and neck

  • Do activities to help you relax and lower stress

If you have chronic tension headaches, doctors may give you medicine. Sometimes medicines for migraines can help treat tension headaches too.

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NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
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