What is a tension headache?

A tension headache is a mild to moderate headache that feels like tightness or pressure around your head.

They are very common — almost everyone will have a tension headache at some point. They may occur from time to time. Some people have chronic tension headache, with symptoms on most days.

What are the symptoms of a tension headache?

The pain caused by a tension headache is on both sides of your head. It might feel like a dull ache, or like something heavy on top of your head. It may feel like pressure or tightness forming a band around your head. Your neck and shoulders may also feel sore.

You might feel sensitive to light or sound.

A tension headache doesn't get worse with movement. However, it may get worse over the course of the day. It might go away after half an hour or so, but it can last for up to a week.

What causes tension headaches?

It's not known what causes tension headaches.

They are not caused by muscle contractions, but muscle tension can make the pain worse.

Other triggers for tension headaches include:

• feeling stressed, tired, anxious or depressed
• poor posture at work, home or when driving
• bright, noisy environments
• eye strain from long periods of reading or screen use
• smoking
• dehydration or withdrawal from caffeine
• overuse of pain-relief medicines

When should I see my doctor?

See your doctor if your headaches:

• are more frequent or more severe than usual
• prevent you from working, sleeping or participating in normal activities
• require pain-relieving medicines more than twice a week

In some cases, headaches can be a symptom of something more serious. See your doctor straight away if you experience:

• a severe headache that comes on suddenly
• a headache that gets progressively worse over the course of several weeks
• a morning headache with nausea that doesn't go away
• a headache that starts following an injury to your head

You should also see your doctor straight away if you have a headache accompanied by:

• fever
• vomiting
• neck stiffness
• confusion or a change in personality
• blurred or double vision
• loss of balance
• a seizure

How are tension headaches diagnosed?

Your doctor will diagnose tension headaches by talking to you and examining you. There is no specific test for tension headaches. However, if your pain doesn't go away, your doctor may do tests to check for other causes of headache.

Keeping a headache diary can help you understand what triggers your headaches. You may want to use these resources for keeping a headache diary.

How are tension headaches treated?

You can ease tension headaches by taking over-the-counter pain-relief medicines, such as paracetamol, ibuprofen or aspirin. Tablets containing pain-relief medicine combined with caffeine can work especially well.

Make sure not to take pain-relieving medicines more than 2 or 3 times a week — this could make your headache worse and harder to treat.

You can also relieve tension headaches by:

• resting
• applying a heat pack
• massaging your neck
• drinking water, if you haven't had enough to drink
• trying acupuncture or physiotherapy

If you get tension headaches frequently, stress management techniques can help reduce how often your headache comes on. You might want to try yoga, meditation, biofeedback training or cognitive behavioural therapy (CBT). Occasionally, your doctor might prescribe you a preventive medicine.

Can tension headaches be prevented?

You can prevent tension headaches by making healthy lifestyle changes:

• Take time for relaxation and stress management techniques.
• Drink plenty of water.
• Get regular exercise.
• Get enough sleep.
• Eat a healthy, balanced diet.
• Improve your posture.

Resources and support

Visit Migraine & Headache Australia to learn more about headache and to join an online support group.

Check out the ANZ Headache Society for helpful tips to manage headache.