These are the most common types of headaches. They can feel like pressing or a tight band around your head.
“Experts originally called it a tension headache because they thought that the muscles were tight or tense," says Jason Rosenberg, MD, director of the Johns Hopkins Headache Center. “It turned out that no study could prove that, and the muscles are actually not tight." Experts now call them “tension-type" headaches.
The pain they cause can come from both sides of your head, but it won’t throb. And you won’t have nausea or vomiting. You may have a stiff or sore neck, jaw, or shoulders, though.
Tension headaches usually aren’t severe, so you’ll probably be able to do your usual activities. Lifestyle changes and medicine can help.
Why Do They Happen?
Doctors aren’t sure of the cause. “We actually understand them extremely poorly compared to migraine, cluster headaches, and other types of headaches," Rosenberg says. “Almost nothing is known about what a tension headache is biologically and medically."
Things that could trigger one include:
- Stress, anxiety, depression, and fatigue
- Sleeping in an awkward position or in a cold room
- Jaw clenching and teeth grinding
- Skipping meals
- Medications — commonly those for heartburn, HIV, and organ transplants
- Too much caffeine, or quitting caffeine suddenly (it’s better to cut down gradually)
- Too much screen time
Physical activity and light typically won’t make tension headaches worse.
How Can I Stop Them?
Improve your sleep. “In many cases, if we can get people sleeping better, that’s good for a variety of headache types," Rosenberg says. “We think it’s good for tension headaches, too."
If you have trouble sleeping at night:
- Don’t nap during the day.
- Avoid caffeine, nicotine, alcohol, and large meals close to bedtime.
- If you can’t sleep, get out of bed. Do something quiet in low light somewhere else (like reading in another room) until you get sleepy.
- Keep your phone, tablet, or laptop out of the bed. The screen’s light can trick your body into thinking the sun is still up and keep you awake. It’s also a bad habit to watch movies, text, or read online when you’re in bed.
- Get up and go to bed at the same times each day.
Curb stress. Smart ways to do so include:
Breathing exercises. Sit or lie down with your eyes closed. Take several long, slow, deep breaths. Get your lungs to fill and your belly to rise. Then breathe out slowly, and repeat.
Meditation. This is simply turning your attention to your breath, a word, an image, or something else that you choose to focus on. Other thoughts will come up. That’s OK. Try not to get wrapped up in them. Just let them go.
It’s not about being a mellow person or following any particular faith. And it doesn’t matter what type of meditation you do, Rosenberg says. They all help. Experiment and find a form that works for you.
Progressive muscle relaxation. Lie down with your eyes closed. Check in on every part of your body, starting with your toes and working up to your calves, thighs, abs, shoulders, and so on. Relax each area as you go.
Medications. You can get relief from an occasional tension headache, Rosenberg says, by taking:
- Aspirin (Don’t use for anyone under 19 because it raises the chances of Reye’s syndrome)
- Caffeine (which is in some pain relievers)
Do you get tension headaches more than four times a month? If so, your doctor may give you a prescription to help prevent them. Medicines include antidepressants, such as amitriptyline or nortriptyline (Pamelor), or anti-seizure drugs, such as gabapentin (Neurontin) or topiramate (Topamax).
- Jason Rosenberg, MD, director, Johns Hopkins Headache Center, Baltimore.
- American Headache Society: “Tension-type headaches: Diagnosis and Management."
- U.S. National Library of Medicine: “Tension-Type Headache."
- National Reye’s Syndrome Foundation: “What is the Role of Aspirin in Triggering Reye’s?"