Tension Headaches

1 What are Tension Headaches?

A tension  headache might be desscribed as a generally diffuse, mild to moderate pain in one's head that is often described as feeling like atight band aroun the the head. A tension headache can also be called a tension-type headache, it is the most occuring type of headache, and yet its causes are not entirely understood. 

There are several treatments for tension headaches. Managing these types of headaches is often a balance between keeping healthy habits, finding effective treatments that do not require  drugs and using medication appropriately.

2 Symptoms

There are various symptoms one can exibit during a tesion headache including the following:

  • A dull, aching pain of tightness or pressure across the forehead or on the sides and back of  the head.
  • tenderness on the scalp, neck and shoulder muscles. 

Tension headaches can be divided into two major categories. These are: 

  • Episodic,
  • chronic. 

Episodic tension headaches usually last from 30 minutes to about a week. Frequent episodic tension headaches occur less than 15 days a month for atleast 3 months. These headaches may become chronic.  

Tension headaches cannot be easily distinguished  from migraines. If one has frequent episodic tension headaches, they can also experince migraines. Unlike some form of migraines, tension headacjes are not associated with symptoms like visual disturbances, nausea or vomiting. 

Although physical activity typically worsens migraine pain, it does not have any effect on tension headaches. An increased sensitivity to either light or sound can occur with a tension headache, but these aren't common symptoms. 

It is important to seek medical attentionwhen tension headache disrupts  daily life or if there is  need to take medication for  headaches more than twice a week.  Occasionally, headaches may indicate a serious medical condition, such as a brain tumor or rupture of a weakened blood vessel (aneurysm). 

Medical attention can also be sought  when one experieces any of these signs or symptoms:

  • abrupt, severe headache
  • headache with a fever,
  • stiff neck,
  • mental confusion,
  • seizures,
  • double vision,
  • weakness,
  • numbness or speaking difficulties,
  • headache after a head injury, especially if the headache gets worse.
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3 Causes

The cause of tension headaches has not yet been established. It was previously assumed that tension headaches were a product of muscle contractions of the face, neck and scalp, perhaps as a result of heightened emotions, tension or stress. 

Further research disprooved this theory and discredited muscle contractions as the cause of tension headaches. The most common theories support a heightened sensitivity to pain in people who have tension headaches and possibly a heightened sensitivity to stress. 

Increased muscle tenderness, a common symptom of tension headache, may result from a sensitized pain system.  Stress is know to be the most common  trigger for tension headaches.

4 Making a Diagnosis

To make a proper diagnosis of tension headaches, your doctor will need as much information as possible about your symptoms.

The initial stages to solving the problem is by first making an appointment with a doctor or general practitioner. An individual may later be referred to a neurologist who specializes in headaches. Here's some information that can be helpful to one to get ready for their appointment and to know what to expect from their doctor. 

Writing down down any symptoms , including any that may seem unrelated to the headaches. Also writing down key personal information, which may include major stresses or recent life changes. Make a list of all medications, vitamins or supplements being taken, and sharing  this information with a  doctor.

It is also vital to write down questions to ask the doctor. For tension headaches, some basic questions to ask include: 

  • What type of headache do you think I'm experiencing? 
  • What tests do I need? 
  • What will these tests rule out? 
  • Is my condition likely temporary or chronic? 
  • What treatments are available? 
  • Which do you recommend? 
  • What are the alternatives to the primary approach you're suggesting? 
  • I have other health conditions. How can I best manage them together? 
  • Are there restrictions I need to follow? 
  • Do I need to see a specialist? 
  • Is there a generic alternative to the medicine you're prescribing? 
  • What are common side effects of the medications you're prescribing? 
  • Do you have any printed material I can take home? 
  • What websites do you recommend? 
  • Don't hesitate to ask other questions, as well. 

What to expect from your doctor?

Your doctor will likely ask you questions, such as: 

  • When did you begin experiencing symptoms? 
  • Have you noticed any common triggers, such as stress or hunger? 
  • Have your symptoms been continuous or occasional? 
  • How severe are your symptoms? 
  • How often do you have headaches? 
  • How long does each headache last? 
  • What, if anything, seems to improve your symptoms? 
  • What, if anything, appears to worsen your symptoms? 

One can take over-the counter medication, such as ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) to temporarily relieve the pain before seeing their doctor. 

To gather information about  headaches that will help the doctor, it is advised to keep headache diary. For each headache, jot down:

  • Date. Charting the date and time of each headache can help one recognize patterns.
  • Duration. How long did the headache last? Intensity. Rate the headache pain on a scale from 1 to 10, with 10 being the worst. 
  • Listing  possible triggers of the headache, such as certain foods, physical activities, noise, stress, smoke, bright lights or changes in weather. 
  • Symptoms. Were there any symptoms before you got the headache? Medications. What medications have been t taken? List any, including dosage, even if they're unrelated to your headache. Relief. Have you experienced any pain relief and from what?

If you have chronic or recurrent headaches, a doctor may conduct physical and neurological exams, then try to pinpoint the type and cause of the headaches using these approaches: Pain description, pain intensity and pain location. 

There are two common tests used to image the brain, these include:

  • Computerized tomography (CT), which is a diagnostic imaging procedure that uses a series of computer-directed X-rays to provide a comprehensive view of the brain,
  • Magnetic resonance imaging (MRI), which has a scan that combines a magnetic field, radio waves and computer technology to produce clear images.

5 Treatment

A good number of individuals don’t seek medical attention for tension headaches and make attempts to treat themselves. Unfortunately, repeated use of over-the-counter (OTC) pain relievers can actually cause overuse headaches.

A variety of medications, both OTC and prescription, are available to reduce the pain of a headache, including: Pain relievers. Simple OTC pain relievers are usually the first line of treatment for reducing headache pain. These include the drugs aspirin, ibuprofen and naproxen. Prescription medications include naproxen, indomethacin and ketorolac. 

Combination medications. Aspirin or acetaminophen or both are often combined with caffeine or a sedative drug in a single medication. Combination drugs may be more effective than are single-ingredient pain relievers. Many combination drugs are available OTC. 

For individuals who experience both migraines and episodic tension headaches, a triptan can effectively relieve the pain of both headaches. Opiates, or narcotics, are rarely used because of their side effects and potential for dependency. Preventive medications a doctor may prescribe medications to reduce the frequency and severity of attacks, especially if you have frequent or chronic headaches that aren't relieved by pain medication and other therapies. 

Preventive medications may include: 

  • Tricyclic antidepressants. Tricyclic antidepressants, including amitriptyline and nortriptyline (Pamelor), are the most commonly used medications to prevent tension headache. Side effects of these medications may include weight gain, drowsiness and dry mouth
  • Other antidepressants. There also is some evidence to support the use of the antidepressants venlafaxine (Effexor XR) and mirtazapine (Remeron) in people who don't also have depression. 
  • Anticonvulsants and muscle relaxants. Other medications that may prevent tension headache include anticonvulsants, such as topiramate (Topamax). Preventive medications may require several weeks or more to build up in the system before they take effect. 

The doctor will usually monitor the treatment to see how the preventive medication is working. In the meantime, overuse of pain relievers for headaches may interfere with the effects of the preventive drugs.

6 Prevention

Apart from regular exercise, others techniques such as biofeedback training and relaxation therapy can help prevent tension headaches.

Biofeedback training is technique teaches one how to control certain body responses that help reduce pain. 

During a biofeedback session, an individual is connected to devices that monitor and give  feedback on body functions such as muscle tension, heart rate and blood pressure.

Another way is by using cognitive behavioral therapy. This type of talk therapy may helps one  learn to manage stress and may help reduce the frequency and severity of headaches. Anything that helps one in the relaxation process, including deep breathing, yoga, meditation and progressive muscle relaxation, may help counter headaches.

Using medications in conjunction with stress management techniques may be more effective than is either treatment alone in reducing  tension headaches. 

Living a healthy lifestyle is always key to preventing headaches, the following healthy lifestyle choices can help:  Getting enough sleep, giving up smoking, exercising regularly, eating balanced meals regularly, drinking plenty of water, limiting alcohol, caffeine and sugar intake.

7 Alternative and Homeopathic Remedies

There are several alternative remedies that may help counter tension headache pain. Some of these treatments include the following: 

  • Acupuncture. This treatment may provide temporary relief from chronic headache pain.  Treatment by thi method is done by using extremely thin, disposable needles that generally cause little pain or discomfort.
  • Massage. Massage can help reduce stress and relieve tension. It's especially effective for relieving tight, tender muscles in the back of the head, neck and shoulders. For certain individuals, it may also provide relief from headache pain. Deep breathing, biofeedback and behavior therapies. 
  • A variety of relaxation therapies are useful in coping with tension headache, including deep breathing and biofeedback.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with tension headaches.

Resting, using ice packs or a long, hot shower may be all one needs to counter atension headache. There are several methods can help reduce the severity and frequency of chronic tension headaches without using medicine. 

The following methods can could can be very helpful: 

  • Managing  stress levels can help one deal with tension heachaches, this can be done by planning or organizing a day ahead of time. Another finding more time to relax. Stepping back in stressful situations is also advised. 
  • Applying heat or ice — whichever you prefer — to sore muscles, may ease a tension headache. For heat, use a heating pad set on low, a hot-water bottle, a warm compress or a hot towel. A hot bath or shower also may help. For cold, wrap ice, an ice pack or frozen vegetables in a cloth to protect the skin. 
  • Good posture can help keep  muscles from tensing. When standing, shoulders should be held back  and the head level. The abdomen and buttocks should be pulled in. When sitting, make sure the thighs are parallel to the ground the your head isn't slumped forward.
  • Living with chronic pain can be difficult. Chronic pain can make you depression and anxiety and also affect relationships, productivity and the quality of one's life. 

Here are some suggestions one can take to help fight against these traits:

  • Talking to a counselor or therapist. Talk therapy may help one cope with the effects of chronic pain.
  • Joining support groups is also known to be part of the solution.

9 Risks and Complications

There are several factors that increase the risks of developing tension headaches. These factors may include the following :

  • A study found that almost 90 % of women and about 70 % of men experience tension headaches during their lifetimes, this study showed that women are more likely to develop tension headaches than men are. 
  • Being middle-aged. People in their 40's  are more likely to develop headaches when compared to other age groups. Because tension headaches are so common, their effect on job productivity and overall quality of life is considerable, particularly if they're chronic. 

Frequent pain cause by these types of headaches may  render one unable to attend  certain activities. In these situation, staying home from work is advised. 

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