How to Identify & Treat Tension Headaches

tension headacheMuscle tension headaches are the most common type of headaches in adults.  They have a tight “band-like” quality on both sides of the head. The headaches are not affected by routine physical activity and they can last from 30 minutes to several days. Pain intensity is mild to moderate.

The frequency is variable, from occasional to chronic daily.  Up to 80% of adults have tension headaches occasionally, and approximately 3% are chronic daily sufferers.  Women tend to have headaches twice as frequently as men.  Most people have only one or two of these headaches a month.

Causes of Tension Headaches

Muscle tension headaches have no single cause. They involve the muscles in the back of the neck or elsewhere in the head tightening up.  The most common cause is mental or emotional stress, or depression with anxiety.   Other common causes include:

  • Poor posture
  • Lack of sleep
  • Overexertion

Understanding the cause of the muscle tension helps determine the possible solutions. Muscle tension headaches are not caused by significant problems in the brain.  Tumors, bleeding in the brain, and brain injuries have different symptoms.  Tension headaches do not require brain scans or sophisticated imaging of the head.  Sometimes fairly routine blood analysis may be helpful to determine if there are any chemical imbalances in the body contributing to the problem.  Most important to the diagnosis is a good history and physical exam.

Treatment for Tension Headaches

Treatment of muscle tension headaches is multifaceted.  Tension and stress most often have physical, mental, and emotional components.  Recognizing and having insight into the factors causing the headaches may be difficult.  Professional help may be necessary to deal with emotional and mental factors contributing to symptoms.  Here are some common treatment options for tension headaches:

  • Medications to deal with stress and anxiety
  • Physical therapy to help with physical components of muscle tension
  • Massage, acupuncture, and manipulations
  • Injections to muscles, joints, and nerves as well as Botox injections

Most people can be treated by their primary physician with good control of symptoms.  When headaches become frequent and are not controlled, Neurologists and Pain physicians can determine a logical more complex and comprehensive treatment and management strategy.

A medical specialist should treat chronic daily muscle tension headaches.  The medications used for occasional headaches may make daily headaches worse.  Pain medications, some anxiety drugs and muscle relaxers can cause rebound headaches and worsening of symptoms.  A specialist can determine different treatment strategies that may be more effective for the individual.

Read more about other types of headaches in our previous blogs:

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Thomas Cohn, MD

Interventional pain doctor helping Minnesotans manage back, neck, foot, and other pain. Board-certified in physical medicine and rehabilitation with additional board-certification in pain management from the American Board of Anesthesiology (ABA), the American Board of Interventional Pain Physicians (ABIPP) and the American Board of Pain Medicine (ABPM).

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