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Tension Headache: Areas of Pain  

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Definition  

Tension headache refers to radiating, steady pain in the head, neck, or eyes that can be mild or intense. Tension headaches may be occasional or chronic.

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Causes  

Tension headaches may occur when muscles in the neck, face, and scalp contract. In some cases, muscle contraction is the result of teeth grinding and jaw clenching. In others, it may be unknown.

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Risk Factors  

Tension headaches are more common in women. Other factors that may increase your chance of getting a tension headache include:

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Symptoms  

Some tension headaches are nearly constant, with daily pain that may vary in intensity, while others occur once in a while. Symptoms usually start slowly and build.

Tension headache may cause:

  • Constant, steady pain and pressure
  • Dull and achy pain
  • Pain which may be felt on both sides of the head, in the forehead, temples, and the back of the head
  • Pressure may feel like a tight band around the head
  • Intensity ranges from mild to severe and can vary during the day
  • Tightness in head and neck muscles

Headaches can become so severe and constant that they interfere with normal activities and sleep.

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Diagnosis  

The doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis can be made on exam, based on specific features. The cause of the headaches however, may be more difficult to determine.

Tests may include:

  • Neurological exam
  • Imaging is not usually needed, but if pain is unusual or severe it may be done to look for other causes of the headache. Imaging tests include:
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Treatment  

There are no specific cures for tension headaches, but they can be managed. Therapies aim to stop the headache and reduce the frequency of future episodes.

Treatment may include:

Medications  

For occasional headaches, your doctor may recommend:

  • Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain
  • Prescription pain relievers

Note: Pain medications are most effective when taken at the first sign of pain and before it becomes severe. Overusing some over-the-counter medications may actually cause headaches. Continuous use of medications may create rebound pain when you stop taking the drug.

For chronic headaches, your doctor may recommend the following to treat or prevent headaches:

  • Antidepressants
  • Muscle relaxers
  • Botulinum toxin injections (Botox)
  • Anti-seizure medication
  • Beta blocker medication

Self-care During the Headache  

Self-care may include:

  • Rest if needed
  • An ice pack or heat pack on your head or neck to ease discomfort
  • A warm shower, with water running over tense muscles