Tension-Type Headaches

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What are "tension-type" headaches?
"Tension-type" headaches are the most common type of headaches among adults. They are commonly referred to as muscle contraction headaches or stress headaches.

A tension-type headache may appear periodically (episodic, less than 15 days per month) or daily (chronic, more than 15 days per month). An episodic tension headache may be described as a mild-to-moderate, constant band-like pain or pressure. These headaches may last from 30 minutes to several days. Episodic tension headaches usually begin gradually, and often occur in the middle of the day.

The "severity" of a tension headache increases significantly with its frequency. This daily or almost daily pain is usually throbbing and affects the front, top, or sides of the head. Although the pain may vary in intensity throughout the day, the pain is almost always present. Chronic tension headaches come and go over a prolonged period of time, but it is important to realize that they do not cause neurological symptoms or affect vision, balance, or strength.

Who is affected by tension headaches?
About 30 to 80 percent of the adult U.S. population suffer from occasional tension headaches. Chronic daily tension headaches affect approximately 3 percent of the population. Women are twice as likely to suffer from tension-type headaches as men.

Most people with episodic tension headaches have them no more than once or twice a month, but the headaches can occur more frequently.

Chronic tension headaches tend to be more common in females. Many patients with chronic tension headaches have usually had the headaches for more than 60 to 90 days. For many headache sufferers, these headaches impair their daily activities.

Chronic tension headaches may co-exist in adults who already have a medical history of migraines. These are called mixed headaches.

What causes tension-type headaches?
There is no single cause for tension-type headaches. This type of headache syndrome is not a trait that runs in families. In some people, tension-type headaches are thought to be caused by tightened muscles in the back of the neck and scalp. This muscle tension may be caused by:

  • Inadequate rest
  • Poor posture
  • Emotional or mental stress, including depression

In others, tightened muscles are not part of tension headaches, and the cause is unknown.

Tension-type headaches are usually triggered by some type of environmental or internal stress. This stress may be known (overt) or unknown (covert) to the patient and their family. The most common sources of stress include family, social relationships, friends, work, and school. Examples of stressors include:

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Last Updated: 9/1/2006

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