Tension Headaches: Causes, Symptoms and Treatment

Tension headaches are the most common of the various types of headache. You can find out here how the complaints develop and what helps against them.

What are tension headaches?

Tension headaches are the most common type of headache – about a third of all Germans experience the mostly dull pressure pain at least once a month. Headaches often occur as a symptom of another disorder, but tension headaches are a separate underlying disorder for which there are various risk factors such as stress or incorrect strain.

The resulting pain is usually difficult to localize exactly, but it occurs on both sides. In addition to classic medication, tension headaches can often be treated by applying peppermint oil to the temples. Tension headaches are usually described as mild to moderate and tend to occur episodically – although the duration of these episodes can vary greatly. In some patients the headache subsides after a few hours, others suffer for several days. Striking: As with migraine, women are more often affected by tension headaches than men.

When are we talking about chronic tension headaches?

There are different forms of the disease, which are called tension headaches depending on their severity:

• Sporadic episodic tension-type headache: mild pain occurring at most once a month and twelve times a year. This type of tension-type headache does not usually require compulsory treatment.
• Frequent episodic tension-type headache: Pain occurring 2 to 14 times a month.
• Chronic tension headache: If the headache persists for 15 days a month and at least three months (180 days a year in total), it is called chronic tension headache.

Causes of tension headaches

The exact causes of tension headaches are not known – however, there are many risk factors that favour the development of headaches. It used to be assumed that the complaints were caused by tension in the neck, throat and shoulder area – hence the name tension headache. Nowadays, however, it is assumed that muscle hardening in these areas of the body actually promotes the development of tension headaches, but other mechanisms also play a role. Among the risk factors are:

• Stress
• Anxiety disorders
• Inner restlessness
• Present diabetes (you can find out what it means to be diabetic here)
• Malpositions
• Overweight
• Existing joint wear and tear, e.g. due to arthrosis
• Incorrect strain on the back muscles (e.g. through frequent sitting)

If a family member already suffers from chronic tension headaches, the risk of becoming ill is about three times higher.

Symptoms of tension headaches

It is important to distinguish tension headaches from migraines. However, the two types of headache are also quite different from each other:

• Tension headaches are often bilateral, migraine is more unilateral
• The pain in tension headaches is often mild to moderate and pressing or pulling, in migraine the pain is pulsating and strong to very strong
• Tension headaches are often relieved by light movement, migraine is more likely to be intensified by this
• With tension headaches there are hardly or no other symptoms, migraine is almost always accompanied by symptoms such as sensitivity to light and noise, nausea and / or vomiting

Treatment: Which therapy helps with tension headaches?

If the headache only occurs now and then, non-prescription drugs, for example with the active ingredient acetylsalicylic acid, usually help. However, if used too often, these drugs can even cause headaches themselves – so you should only use them on three consecutive days at most, and no more than ten days a month. Alternatively, the following measures can relieve acute pain:

• Fresh air: A short walk in the fresh air actually often helps and makes the tension headaches go away.
• Peppermint oil: A study has shown that peppermint oil significantly improves the symptoms of acute tension headaches compared to a placebo and can even keep up with the effect of medication. Simply massage one drop each gently into the temples or neck on the left and right side.

Pain in the head? When you should see a doctor!

Caution: If you notice that you can only treat your symptoms with a higher dose of painkillers, you should see your doctor as soon as possible and seek advice.

Preventing tension headaches: How it works

Otherwise, it is important to reduce the known risk factors in order to prevent tension headaches as much as possible – then they do not need to be treated at all. Stress, for example, should be reduced as much as possible. Many patients find that endurance sports can help them to balance out their stressful everyday lives, for example jogging or swimming. Tense muscles can be loosened by targeted training and massage applications.

Relaxation techniques such as autogenic training can also help. Those who are susceptible to tension headaches should also make sure that they always drink enough – two to three litres a day should be enough.