A tension headache is characterized by a dull, achy pain in the head, neck or scalp. It is the most common form of headache.

According to the American Pain Foundation, tension headaches account for 90 percent of headaches not due to disease. The headaches typically cause pain on both sides of the head as well as the back of the neck and at the base of the skull. They may also produce a sensation of tightness in the forehead or at the temples. Many patients compare the pressure of a tension headache to the sensation produced by wearing a tight band around the head or neck.

The level of pain associated with a tension headache may fluctuate throughout the course of the headache. This pain, which may be mild or moderate, may last anywhere from 30 minutes to a week. The severity of the pain varies from patient to patient, as well as from episode to episode in the same person. The frequency of the headaches also varies. Though some patients may experience them often, others may experience tension headaches only occasionally. In most cases, the pain develops early in the day, usually soon after a patient wakes up.

Tension headaches can interfere with a patient’s daily life. The pain associated with the condition often prevents a person from attending work and social activities. Although they are bothersome, tension headaches are not usually a symptom of an underlying disease. In some cases, however, head pain may indicate a more serious underlying condition such as a brain tumor, stroke or aneurysm.

Patients should discuss all severe, persistent or recurring headaches with their physician and seek medical attention when a headache:

• Disturbs sleep
• Occurs with activity
• Does not improve with treatment
• Changes in pattern or intensity
• Is accompanied by other symptoms, such as drowsiness, nausea and vomiting, vision changes, changes in movement or sensation or changes in alertness

Patients should seek emergency medical treatment when:

• A headache is accompanied by unusual symptoms not experienced with previous headaches, including:
  
  
• Speech problems
• Vision abnormalities, such as double vision
• Numbness, weakness or loss of balance
• Fever
• Stiff neck
• Rash
• Seizures
• Mental confusion
  
  
• A severe headache occurs abruptly
  
  
• A headache occurs after a head injury
  
  
• A chronic headache intensifies with coughing, exertion, straining or sudden movement
  
  
• A new type of headache pain occurs (in those over age 50 or younger than 8)