Tension headaches, also known as stress headaches, are pain, pressure, or discomfort felt in and around the head, scalp, or neck. The mild to moderate pain is characterized by tightness in these areas and it’s often described as a clamp squeezing the skull or a tight band around the head. Tension headaches are the regarded as the most common types in adults and older teens.
Tension headaches causes are not well-understood but they may occur when neck and scalp muscles become tense, or contract. This tension or contraction may be due to stress, depression, head injury, or anxiety. Activities that cause the head to held in place for a long time without moving can cause a tension headache. Such activities include typing or other computer work, delicate work with the hands that requires concentration, and using a microscope for a long time. Also, sleeping with the neck in an abnormal position may also trigger a tension headache. Other triggers of tension headaches are inadequate rest, physical or emotional stress, binge drinking, eye strain, caffeine (too much or withdrawal), dental problems, excessive smoking, and fatigue or overexertion.
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It is reported that up to 80% of adults in the U.S. have them from time to time. About 3% get chronic daily tension headaches. Women are twice as likely to develop them as men.
Signs and symptoms of tension headaches include the following:
There are two main types of tension headaches. They are the episodic and chronic types.
Though one’s head is hurtful, tension headaches don’t usually prevent one from one’s daily activities, and they don’t affect one’s sight, balance, or strength.
How Are Tension Headaches Diagnosed?
If a patient has chronic headaches, physical and neurological tests may be carried out by a doctor to try and identify the type and cause of the headache using the following approaches:
Pain description: providing an adequate description of the pain can help a doctor to accurately diagnose the headache. So, an adequate description of the pain given by the patient should include the following details:
Imaging tests: A doctor may order imaging tests to be carried out in the case of unusual or complicated headaches. This is done so as to rule out serious causes of head pain, such as brain tumor. The imaging tests carried out are:
Other tests include blood tests to analyze blood chemistry and laboratory tests to check for any underlying conditions.
What Are The Treatment Options Available?
Tension headaches are best treated when the pain is still mild. So as soon as you experience any unusual pain in your head, you should visit a doctor. Some people try to treat the pain on their own using over-the-counter pain relievers, which eventually complicate the pain due to repeated use, and can actually cause another type of headache called overuse or rebound headaches.
Also learning to manage tension headaches at home is important as it can help to improve on the treatment plan and can also help provide additional information to the doctor during medical check-ups for better treatment plan. Ways of managing tension headaches at home include:
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There are various medications, prescriptions and over the counter (OTC) drugs, that can be taken to reduce the pain of tension headaches. These are called acute medications and they include:
Doctors may also prescribe medications to help reduce the occurrence and intensity of attacks, particularly if one has chronic headaches that are not alleviated by simple medications and other therapies. These medications are called preventive medications and they include:
Preventive medications may take time to exert their effects, usually several weeks or more. This is specifically emphasized, so the patient doesn’t get frustrated if after they begin the drugs and don’t see any immediate improvements. The doctor monitors the progress of the treatment to see how the preventive medication works. During this period, continued use of pain relievers may interfere with the actions of the preventive medications.
Other alternative ways that may help provide relief from tension headaches include nontraditional therapies such as acupuncture- the use of extremely thin, disposable needles that cause little pain to bring about temporary relief from chronic headache pain. Massage can also be a helpful way to alleviate stress and relieve tension. Particularly effective for relieving tight, tensed up muscles in the neck, shoulders and back of the head, it may relieve one from headache pain. Deep breathing, behavior therapies and biofeedback can also help cope with tension headaches.
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Brian J. Hall; John C. Hall. “Infectious diseases in the skin”. Sauer’s Manual of Skin Diseases. Lippincott Williams & Wilkins, 2010. p. 232.
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