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Muscle tension headaches, also known as tension-type headaches (TTH), are the most common type of primary headache. They are characterised by mild to moderate constant pressure and pain, often described as feeling like something is squeezing the sides of the head. The pain usually starts in the neck and shoulder muscles and radiates to the forehead, causing tightness, pressure, or a dull ache. While the exact cause of TTH is unknown, they are often associated with stress, poor posture, muscle tension, and emotional conflict. They can last anywhere from 30 minutes to a week, with an average duration of 4 to 6 hours.
| Characteristics | Values |
|---|---|
| Common names | Tension-type headache (TTH), Muscle contraction headache, Stress headache, Psychomyogenic headache |
| Pain | Mild to moderate, dull, radiating, poorly localized, aching |
| Pain location | Forehead, temples, neck muscles |
| Pain description | Tightness, pressure, squeezing |
| Duration | 30 minutes to 7 days |
| Frequency | Episodic, infrequent, chronic |
| Treatment | Over-the-counter medicines (acetaminophen, ibuprofen, naproxen, antihistamines, antiemetics), prescription medicines, physical therapy, lifestyle changes, relaxation therapy, biofeedback |
| Prevention | Regular sleep, exercise, meals, stress management, meditation, good posture, avoiding triggers |
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What You'll Learn
Muscle tension headache causes
Tension-type headaches (TTH) are the most common type of primary headache. They are also referred to as muscle contraction headaches, stress headaches, or psychomyogenic headaches. TTH occurs repetitively and may be categorized into episodic TTH, with frequent and infrequent subtypes, and chronic TTH. The differentiating factor for these types is the frequency of headache episodes. The average duration of a TTH episode is about 4 to 6 hours, but they can last anywhere from 30 minutes to 7 days.
TTH is often linked to stress, poor posture, and muscle tension, with a multifactorial etiology involving both peripheral and central mechanisms. The pathogenesis is thought to involve heightened sensitivity of the central nervous system, particularly in the trigeminal system, and muscle contraction in the head and neck region. The pain of TTH is thought to have a muscular origin, with sustained sensory input contributing to the sensitization of the peripheral nervous system.
Some common triggers for tension headaches include:
- Stress and emotional conflict
- Poor posture
- Neck strain from looking down to read or holding a phone between your head and shoulder
- Sleeping in a cold room or with the neck in an abnormal position
- Any activity that causes the head to be held in one position for a long time without moving, such as typing or other computer work, fine work with the hands, or using a microscope
It is important to identify and avoid headache triggers, and to practice stress management and good posture. Keeping a regular sleep, exercise, and meal schedule can also help reduce the occurrence of tension headaches.
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Muscle tension headache symptoms
Muscle tension headaches, also known as tension-type headaches (TTH), are the most common type of primary headache. They are characterised by mild to moderate constant pressure and pain, often described as feeling like something is squeezing the sides of the head. This pain may also manifest as a dull ache in the forehead, or across the forehead and temples.
TTH is associated with muscle tenderness and contraction, particularly in the neck and scalp. Those experiencing TTH may feel tightness in their neck and shoulder muscles, as well as muscle soreness. This muscle tension may be caused by stress, poor posture, or emotional conflict. Other causes include neck strain from looking down for long periods, sleeping in a cold room, and sleeping with the neck in an abnormal position.
The headaches can last anywhere from 30 minutes to a week, with an average duration of 4 to 6 hours. They are usually milder in the morning and worsen as the day progresses. TTH is not aggravated by routine physical activity, meaning those experiencing it can continue their daily activities, unlike migraine patients who often require a quiet, dark room.
TTH can be differentiated from other types of headaches by its frequency, with at least 10 headache episodes required for a diagnosis. They may be further categorised into episodic TTH (frequent and infrequent subtypes) and chronic TTH, depending on how often they occur.
If you are experiencing symptoms of tension headaches, it is important to talk to a healthcare provider. They will be able to recommend lifestyle changes, treatments, or refer you to a specialist if needed.
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Muscle tension headache triggers
Tension-type headaches (TTH) are the most common type of primary headache. They are also referred to as muscle contraction headaches, stress headaches, or psychomyogenic headaches. TTH can be episodic or chronic, and they can last anywhere from 30 minutes to a week.
TTH is often linked to stress, poor posture, and muscle tension. Emotional conflict, depression, anxiety, and head injuries can also trigger tension headaches. In addition, any activity that causes the head to be held in one position for a long time without moving can cause a headache, such as typing, fine work with the hands, using a microscope, or reading in bed. Sleeping in a cold room or with the neck in an abnormal position may also trigger a tension headache.
Some people find that relaxation exercises or meditation help with stress management, which can reduce the frequency of tension headaches. Biofeedback may also help improve the effect of relaxation exercises and is recommended for those with chronic tension headaches.
It is important to identify tension headache triggers to manage them effectively. Keeping a headache diary can help patients and healthcare providers understand the triggers and make the necessary lifestyle changes to reduce the number of headaches.
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Muscle tension headache treatment
Tension headaches are the most common type of headache. They are often associated with muscle tightness in the head, scalp, or neck. While the exact cause of tension headaches is not known, they are believed to be brought on by stress, depression, anxiety, poor posture, and sleep issues.
If you are experiencing tension headache symptoms, it is important to talk to a healthcare provider. They will ask you questions to understand the cause of your symptoms and recommend suitable treatment options.
Lifestyle Changes
Lifestyle changes are often recommended to reduce stress and prevent tension headaches. These include:
- Regular sleep, exercise, and meal schedules
- Getting plenty of sleep and rest
- Maintaining good posture during activities such as reading or working
- Regularly exercising the neck and shoulders, especially when working on computers or doing other close work
- Practicing relaxation techniques such as meditation, yoga, or biofeedback
- Massaging sore muscles
Medication
Over-the-counter medicines can be effective in treating tension headaches. These include:
- Acetaminophen (also known as paracetamol)
- Ibuprofen
- Naproxen
- Aspirin
- Antidepressants (e.g., amitriptyline)
It is important to note that taking painkillers too often or for a prolonged period can lead to overuse or rebound headaches. Therefore, it is advisable to consult a healthcare provider about the appropriate use of medication.
Alternative Treatments
If painkillers and lifestyle changes do not provide relief, a GP may refer you to a specialist for alternative treatments, such as acupuncture.
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Muscle tension headache prevention
Muscle tension headaches, also known as tension-type headaches (TTH), are the most common type of primary headache. They are characterised by mild to moderate constant pressure and pain, often described as feeling like something is squeezing the sides of the head. This can be accompanied by tight neck and shoulder muscles, and sensitivity to light and sound. While the exact cause of TTH is not known, they are often linked to stress, poor posture, and muscle tension.
- Keep a headache diary: Note the frequency, duration, severity, and any aggravating or relieving factors of your headaches. This can help you identify triggers and make informed lifestyle changes to reduce the frequency of your headaches.
- Stress management: Learn relaxation techniques such as meditation and biofeedback, which can help you manage stress and reduce the occurrence of tension headaches.
- Posture: Practise good posture when reading, working, or doing other activities. Poor posture is a common trigger for muscle tension headaches.
- Exercise: Frequently exercise your neck and shoulders, especially when working on computers or doing other close work. This can help prevent muscle tension and headaches.
- Sleep: Ensure you get plenty of sleep and rest. Fatigue and lack of sleep can contribute to muscle tension and headaches.
- Massage: Massage sore muscles to relieve tension and prevent headaches.
- Medication: Consult with your healthcare provider about taking over-the-counter pain medications or prescription medications to prevent and manage tension headaches.
- Physical therapy: In some cases, physical therapy may be recommended to help manage and prevent tension headaches.
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Frequently asked questions
Muscle tension headaches, also known as tension-type headaches (TTH), are the most common type of primary headache. They are characterised by recurrent, mild to moderate, dull, pressing, or tightening pain that is usually felt on both sides of the head.
The exact cause of muscle tension headaches is not fully understood. However, they are often associated with stress, poor posture, muscle tension, and emotional conflict. They can also be triggered by certain activities that involve holding the head in one position for a prolonged period, such as reading or computer work.
The symptoms of a muscle tension headache include constant mild to moderate pressure and pain, feeling like something is squeezing the sides of your head, aching or tight neck and shoulder muscles, and sensitivity to light and sound. These symptoms can last anywhere from 30 minutes to a week.
Treatment for muscle tension headaches involves managing stress, improving posture, and taking over-the-counter pain medications like acetaminophen, ibuprofen, or naproxen. Keeping a headache diary can also help identify triggers and develop strategies to reduce the frequency and intensity of headaches. For chronic cases, prescription medications or physical therapy may be recommended.
