Tension headache

What is a tension headache?

A tension-type headache (TTH) or tension headache is a type of headache that usually radiates from the lower back of the head, causing a persistent, dull pain. The duration and frequency of TTH attacks or episodes depends on your individual case: when it is sporadic, an attack usually lasts 30 minutes to several hours, but can last several days. Chronic TTH can involve long-lasting and/or recurrent headaches that occur frequently over a period of weeks, months, or even years. Tension-type headaches can be classified according to its frequency:

  • Infrequent episodic: a headache occurring occasionally or once a month
  • Frequent episodic: from one to 15 attacks per month
  • Chronic: occurring more than 15 times a month

What are the symptoms?

The symptoms of tension-type headache are a persistent, dull headache on both sides of the head. The pain can be mild to moderate and it usually affects the occipital area. Furthermore, you may also develop sensitivity to light and sound. You may experience a pain that is usually described as if the head were being squeezed in a vice.

How is it diagnosed?

There is usually no need to see a doctor if you only suffer headaches occasionally; however, if your headaches are severe or you get them several times a week, you should see your GP. TTH can be diagnosed by simply describing the symptoms you are suffering from.

If the doctor suspects a more serious condition is behind your headaches, they may send you for tests, such as CT or MRI scans.

What causes tension headaches?

It is not clear yet what causes tension-type headaches; however, it has been hypothesised that they may be caused by a prolonged contraction of the muscles on the lower back of the head, of the forehead, temples, neck and shoulders. TTH may be triggered by stressful events, anxiety or depression, which is why it may be regarded as a psychosomatic condition. Furthermore, tension-type headaches can also be associated with problems of the mandibular joint, hormone imbalance, poor posture and misuse of medications.

How are tension headaches treated?

Chronic TTH tends to be treatment resistant, but frequent and infrequent tension-type headaches can be treated with medication, biofeedback therapy, and massage therapy. Other treatments, such as cognitive-behavioural therapy and stress management techniques, may be beneficial as well.

Which doctor should I see?

If you are suffering from repeated or chronic tension-type headaches, you should see your GP. Depending on the nature of the headaches, you may be referred to a specialised neurologist, psychologist or dental practitioner.

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