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NeurologicalICD-10: G44.209Affects approximately 38% of the global population

Tension Headache

Also known as: Tension-Type Headache, Stress Headache, Muscle Contraction Headache

Tension headaches are the most common type of headache, producing a dull, aching pain that typically feels like a tight band wrapping around the head, often accompanied by tenderness in the scalp, neck, and shoulder muscles. They can be episodic (occurring fewer than 15 days per month) or chronic (occurring 15 or more days per month for at least 3 months). Unlike migraines, tension headaches usually do not cause nausea, vomiting, or sensitivity to light and sound, though they can significantly affect daily functioning and quality of life.

Symptoms

Dull, aching head pain on both sides of the head
Sensation of tightness or pressure across the forehead or sides and back of the head
Tenderness in the scalp, neck, and shoulder muscles
Difficulty concentrating
Mild sensitivity to light or noise (but not both)
Irritability and fatigue
Trouble sleeping due to headache

Causes

  • Muscle tension and contraction in the head, neck, and shoulder region
  • Stress, anxiety, and emotional tension
  • Poor posture, especially during prolonged computer use or desk work
  • Eye strain from prolonged screen time or uncorrected vision problems
  • Jaw clenching or teeth grinding (bruxism)

Risk Factors

  • High stress levels at work or home
  • Female sex (women are more commonly affected)
  • Age between 20 and 50 years
  • Poor posture or ergonomic setup
  • Insufficient sleep or irregular sleep patterns
  • Skipping meals or dehydration

Diagnosis

  • Clinical diagnosis based on headache characteristics and history
  • Neurological examination to rule out other causes
  • MRI or CT scan if headache pattern changes or atypical features are present
  • Headache diary tracking frequency, triggers, and severity

Treatment

  • Over-the-counter pain relievers (acetaminophen, ibuprofen, aspirin)
  • Combination analgesics containing caffeine for enhanced effectiveness
  • Tricyclic antidepressants (amitriptyline) for chronic tension headache prevention
  • Muscle relaxants for tension headaches associated with muscle spasm
  • Stress management techniques including cognitive behavioral therapy
  • Physical therapy for neck and shoulder tension

Prevention

  • Practice stress management through regular exercise, meditation, or yoga
  • Maintain proper posture and take frequent breaks during desk work
  • Get adequate sleep on a consistent schedule
  • Stay well-hydrated and eat regular meals
  • Limit caffeine intake and avoid caffeine withdrawal
  • Use ergonomic workspace setups to reduce neck and shoulder strain

When to See a Doctor

  • Headaches occur 15 or more days per month for 3 or more months
  • Over-the-counter medications are no longer effective
  • Headache pattern changes suddenly or becomes unusually severe
  • Headaches are accompanied by fever, stiff neck, confusion, or vision changes

Frequently Asked Questions

Related Conditions

Migraine

Neurological

Insomnia

Mental Health

Depression

Mental Health

Anxiety Disorders

Mental Health

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.