Tension headaches, the most common type of headache, produce a dull and pressure-like pain in the head, neck and scalp. They are usually mild but can become debilitating in some people.

Head pain associated with a tension headache is usually generalized, with areas of more intense pain in the scalp, forehead, temples or the back of the neck. In addition, the condition can cause pressure that is similar to the sensation of having a vice or a tight band on the head or around the neck. The severity of a tension headache varies from patient to patient, as well as from headache to headache in the same person. In many people, tension headaches are accompanied by other symptoms including neck or jaw discomfort and tenderness in the scalp, neck and shoulder muscles.

Tension headaches may occur occasionally or as frequently as every day. Tension headaches that occur on fewer than 15 days a month are referred to as episodic, and those occurring on 15 days a month or more for at least six months may be described as chronic. Each episode may last anywhere from 30 minutes to a week. During this time, the intensity of the pain may fluctuate. This type of headache typically develops early in the day, often after a person wakes up.

The exact cause of tension headaches remains unknown. For many years, experts have believed the condition is triggered by the contraction of neck and scalp muscles. More recently, some experts have investigated the theory that the condition results from changes in brain chemicals. Researchers, however, have been able to identify a number of factors that may trigger a tension headache. These include stress, depression and anxiety.

Although tension headaches can interfere with a patient’s daily life, they are usually not a symptom of an underlying disease. In some cases, however, a number of serious conditions (e.g., brain tumor, aneurysm) can cause headaches that may be mistaken for tension headaches. A physician evaluates the patient by taking a medical history and performing a physical examination. Imaging studies such as MRI or CAT scan may be performed to rule out other conditions.

Tension headaches cannot be cured. However, there are a number of methods used to control symptoms and prevent future episodes. These include such headache medications as analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs). Other pain management methods, such as acupuncture, may also be used. Patients may also prevent tension headaches by altering their lifestyle to avoid factors that trigger the headaches. 

The American Pain Foundation estimates that tension headaches account for 90 percent of headaches not due to disease. Although they can occur at any age, tension headaches are most common in patients in their 30s and in women.   

Patients should seek emergency medical treatment when a headache is accompanied by symptoms not experienced with previous tension headaches (e.g., speech problems, vision abnormalities) as it may indicate a more serious medical condition.