Medical Information from the Cleveland Clinic: Migraines and Headaches: Tension Headaches

Tension headaches are the most common type of headaches among adults. They are commonly referred to as stress headaches.

A tension 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, tightness or pressure around the forehead or back of the head and neck.

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. Chronic tension headaches come and go over a prolonged period of time. The 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 do not affect vision, balance or strength.

Tension headaches do not keep a person from performing daily tasks.

Who Gets Tension Headaches?

About 30%-80% of the adult U.S. population suffers from occasional tension headaches; approximately 3% suffer from chronic daily tension headaches. 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 people with chronic tension headaches have usually had the headaches for more than 60-90 days.

What Causes Tension Headaches?

There is no single cause for tension headaches. This type of headache is not an inherited trait that runs in families. In some people, tension headaches are 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
• Anxiety
• Fatigue
• Hunger
• Overexertion

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

Tension headaches are usually triggered by some type of environmental or internal stress. The most common sources of stress include family, social relationships, friends, work and school. Examples of stressors include:

• Having problems at home/difficult family life
• Having a new child
• Having no close friends
• Returning to school or training; preparing for tests or exams
• Going on a vacation
• Starting a new job
• Losing a job
• Being overweight
• Deadlines at work
• Competing in sports or other activities
• Being a perfectionist
• Not getting enough sleep
• Being over-extended (involved in too many activities/organizations)

Episodic tension headaches are usually triggered by an isolated stressful situation or a build-up of stress. Daily stress can lead to chronic tension headaches.