HEADACHE, TENSION (Stress Headache)

General Information

DEFINITION--Tension headaches are the most common type of headache. These headaches can occur infrequently, such as one brought on by a stressful event, or they can occur on a chronic basis (15 or more times a month for 6 months). Symptoms may be mild to severe.

BODY PARTS INVOLVED--Sensory nerves in the skin, scalp, blood vessels and muscles of the head.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS--

Any of the following:

• Dull, aching feeling on both sides of the head.
• Tight muscles in the neck or scalp.
• Not preceded by warnings (aura, prodrome).
• Feelings of fatigue, weakness.
• If severe, nausea, light and sound sensitivity.

CAUSES

• Tension, producing strain on muscles of the neck, scalp, face and jaw.
• Clenching or grinding of the teeth.
• Sleep disturbances; anxiety or depression.
• Excessive eating or drinking.
• Physically exhausting work.
• Eye strain, including sun glare.
• Use of drugs or alcohol; low blood sugar.
• Hormone changes during the menstrual cycle.
• Allergic reactions.

RISK INCREASES WITH

• Stress, either mental or physical.
• Environments that are noisy, stuffy, hot, poorly lit or have irritating odors.
• Exposure to or consumption of nitrites, sulfites, monosodium glutamate or other food additives.
• Maintaining a sitting position for long periods (typing).

> Get enough sleep--

an average of 8 hours for men and 7 hours for women.

• Don't skip meals; don't overeat; don't smoke.
• Exercise regularly to improve circulation.
• Drink alcohol moderately--no more than 1 or 2 drinks a day, if at all.
• Don't use mood-altering, mind-altering, stimulant or sedative drugs.
• Avoid foods that contain nitrites or other additives to which you are sensitive.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Diagnostic tests are usually not needed, but may be indicated if a serious underlying cause is suspected.

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment, if headache persists.
• Biofeedback training relaxation therapy, hypnotherapy are sometimes useful.

POSSIBLE COMPLICATIONS--None expected for most tension headaches. Rebound headaches can occur from long-term use of analgesics.

PROBABLE OUTCOME--Most tension can be relieved (see How to Treat).

How To Treat

GENERAL MEASURES--

• If possible, take a break.
• Massage shoulders, neck, jaw and scalp.
• Take a hot bath or long shower.
• Lie down. Place a warm or cold cloth (or ice packs), whichever feels better, over the aching area.
• For jobs requiring long hours of sitting, be sure to get up and move around at least hourly.
• Identify your headache triggers: keep a record of the time and duration of each headache, what foods or drinks you consumed in the previous 12 hours; list any physical, emotional or personal factors that occurred prior.
• See Resources for Additional Information.

MEDICATION--

• You may take acetaminophen or aspirin to relieve pain.
• Your doctor may prescribe: Nonsteroidal anti-inflammatory medications. Antianxiety drugs if anxiety is a problem; antidepressants if headaches are chronic. Stronger pain medicines; muscle relaxants.

ACTIVITY--Participate in a regular physical fitness program. Focus on exercises that help muscles in the back, shoulders and neck.

DIET--

• Most persons feel better if they don't eat, unless the headache is from low blood sugar.
• Don't drink alcohol.

Call Your Doctor If

You have a headache and any of the following:

• Fever; recent head injury.
• Drowsiness; nausea or vomiting.
• Pain in one eye; blurred vision; vision disturbances and vomiting prior to the headache; high blood pressure.
• Pain and tenderness around the eyes and cheekbones that worsens when you lean forward.
• Persistent headache pain for longer than 24 hours without other symptoms.
• You suspect a drug caused the headache.