Tension Headaches

Tension headaches are dull pain, tightness, or pressure around your forehead or the back of your head and neck. Some people say it feels like a clamp squeezing the skull. Often called stress headaches, they’re the most common type for adults.

Video Transcript

Michael Smith, MD<br />Chief Medical Editor at WebMD

MICHAEL SMITH: The differences between tension and migraine headaches aren't absolute, meaning there's overlap. So for instance, migraine headaches, we tend to think of as more severe. But it's not to say that someone with a tension headache can't have a severe headache. But generally, when we think about a migraine headache, we think about a sudden, severe headache that just comes out of nowhere, pounding, throbbing pain. Might be one side of the head or the other. People with migraine headaches typically have nausea. They might have noise and light sensitivity, meaning they just want to curl up in a dark, quiet room somewhere. Now tension headache sufferers can have some of these characteristics, but typically it tends to come on bit more slowly, a bit more moderate, can affect the entire head, but not that throbbing kind of pain. Usually no nausea, and typically, they don't have noise and light sensitivity.

When you get them less than 15 days per month, they’re called episodic tension headaches. If they happen more often, they’re called chronic.

These headaches can last from 30 minutes to a few days. The episodic kind usually start gradually, often in the middle of the day.

Chronic ones come and go over a longer period of time. The pain may get stronger or ease up throughout the day, but it’s almost always there.

Although your head hurts, tension headaches usually don't keep you from your daily activities, and they don’t affect your vision, balance, or strength.


Who Gets Them?

Up to 80% of adults in the U.S. get them from time to time. About 3% have chronic daily tension headaches. Women are twice as likely to get them as men.

Most people with episodic tension headaches have them no more than once or twice a month, but they can happen more often.

Many people with the chronic type have usually had them for more than 60-90 days.

What Causes Tension Headaches?

There's no single cause for them. Most of the time, they’re triggered by stress, whether from work, school, family, friends, or other relationships.

Episodic ones are usually set off by a single stressful situation or a build-up of stress. Daily strain can lead to the chronic kind.

This type of headache doesn’t run in families. Some people get them because of tightened muscles in the back of the neck and scalp. This muscle tension can come from:

For others, tightened muscles aren’t part of tension headaches, and there’s no clear cause.

What Are the Symptoms?

A few common ones are:

  • Mild to moderate pain or pressure in the front, top, or sides of the head
  • Headache that starts later in the day
  • Trouble sleeping
  • Feeling very tired
  • Irritability
  • Trouble focusing
  • Mild sensitivity to light or noise
  • Muscle aches

Unlike migraine headaches, you won’t have other nerve symptoms, such as muscle weakness or blurred vision. And they don’t usually cause severe sensitivity to light or noise, stomach pain, nausea, and vomiting.

How Are They Treated?

It’s best to treat tension headaches when they first begin and the symptoms are still mild. The goal is to prevent more of them from happening and to relieve any pain you're already in. For prevention, you can:

  • Take medications
  • Avoid the causes or triggers
  • Manage your stress or learn relaxation techniques
  • Practice biofeedback
  • Try home remedies, like a hot bath, ice packs, or better posture

Over-the-counter (OTC) painkillers are often the first treatments doctors recommend for tension headaches. People with the chronic kind can use some of these drugs to prevent headaches.


If OTC pain relievers don't help, your doctor may recommend a prescription-strength med or a muscle relaxant.

Some drugs can keep you from getting a tension headache, like antidepressants, blood pressure meds, and anti-seizure drugs. You take them every day even if you aren’t in pain, so that you end up using less medication over time.

Keep in mind that medications don't cure headaches and that, over time, pain-relievers and other drugs may not help as much as they did at first. Plus, all medicines have side effects. If you take one regularly, including products you buy over-the-counter, discuss the risks and benefits with your doctor. You'll still need to find out and deal with the things that are causing your headaches, too.

WebMD Medical Reference Reviewed by Neil Lava, MD on May 06, 2018



National Institute of Neurological Disorders and Stroke: "Headache: Hope Through Research."

National Headache Foundation: "Tension-Type Headache."

MedlinePlus Medical Encyclopedia: "Tension headache."

American Headache Society: "Types of Headaches."

University Health Services, University of California, Berkeley: "Tension Headache Fact Sheet."

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