Tension headache is a very common type of headache. Unlike the name suggests, the headache is probably not caused by tension. Tension headache is characterized by a dull pressing pain at both sides of the head, as if the head is trapped by a tight band. Tension headache falls under the heading of ‘headache’.


The cause of tension headache is not fully known. The condition was formerly particularly attributed to an increased tension in the muscles of the neck, shoulders and face. The increased muscle tension is caused by psychological and physical factors.
With psychological factors, one can think of tension and stress at home, at work or at school. Sometimes, people suffer just in weekends from headache, when the weekday stress disappears. Anxiety and depression can also cause tension headache.
Physical causes of the increased muscle tension are a wrong body posture, making the same movement repeatedly and great effort. Lack of sleep can also trigger the headache.
The role of muscle tone in the development of tension headache is, however, more often being questioned. The original thought is more and more replaced by the idea that stretching the membranes under the skull by the tendons of the muscles causes the condition.
Heredity probably also plays a role in the development of tension headache.


The signs and symptoms of tension headache are as follows:

By distraction or relaxation, the pain may reduce. It often passes when sleeping.


The diagnosis of tension headache is made on the basis of the story of the patient and when the headache doesn’t comply with other diagnoses of headache, such as migraine and cluster headache. Additional examination, such as blood tests or imaging studies to demonstrate other causes of the headache, are usually not necessary.


If a person suffers from tension headache, he or she can initially try to eliminate the pain by some adjustments of lifestyle. Getting enough sleep, doing regular stretching exercises at work and trying to find relaxation in physical exercises and massages can, for example, be very effective. Keeping a headache diary can be a useful way to gain understanding in the pain pattern in order to tailor the treatment together with the general practitioner.
In case lifestyle changes don’t benefit, then one can try to ease the pain with paracetamol or an anti-inflammatory painkiller, such as ibuprofen. However, these drugs should not be used too often or for too long, because the patient can suffer from side effects then, including more headaches.


No prediction can be made about the course of tension headache and how the headache develops further. Avoiding triggering factors can increase the control over the headache. Long-lasting tension headache can lead to depression.