Tension Headache

Tension headaches or muscle contraction headaches are very common. They probably represent 80 percent of all of the headaches seen by primary care doctors. These headaches are seen in up to 70 percent of men and as many as 90 percent of women.

Tension Headache Cause

Tension headaches are related to a number of factors. Some common causative factors include tension, stress, anxiety, depression, fatigue and eye strain. There may be an association with cervical spine degenerative disease.

Tension Headache Symptoms

The most obvious symptom is a headache that is described as a steady ache, pressure, tightness and a band-like sensation. There may be pain in the back of the neck. The headache is described as mild to moderate and may last from a few hours to a few days. They may become chronic. Tension headaches may be seen in association with migraine headache.

Tension Headache Diagnosis

As always, a careful history and physical examination are the first steps in diagnosis. Imaging studies such as CT scans and MRI scans are usually not needed if the diagnosis is straightforward. However, if there are unusual aspects to the diagnosis or presentation, then scanning may be warranted. Some things that may lead to scanning include increasing headache frequency, dizziness or coordination changes, numbness or tingling, weakness, headaches that wake the patient from sleep and new onset of headaches in older patients.

Tension Headache Treatment

Lifestyle adjustments may help with tension headaches. Most respond to over-the-counter pain relievers. In some cases, short term use of prescription medications may be tried. Some patients respond to antidepressants or beta-blockers. The treatment is individual and most patients do not seek treatment with a doctor until after usual medications have failed.