There are many different forms of headaches. Neurologists divide them into tension headache, cluster headache, migraine and medication-induced headache. Of these four forms, tension headache is the most common. Read all about symptoms, causes and treatment of tension headache here.
What are the symptoms of tension headache?
A typical symptom of tension headache is a dull, pressing headache that is usually bilateral but cannot be pinpointed. “Like a band around the head” or “vice-like” are common descriptions of the discomfort. In addition, the following characteristics can often be observed in tension headaches:
- The intensity is mild to moderate.
- The duration of the pain varies greatly and can range from a few hours to days.
- Rarely, it is accompanied by dizziness.
- Differentiated from other forms of headache, there is no aggravation of symptoms by physical exertion and no pulsation.
- Involvement of the neck and cervical muscles is common. The pain radiates from the neck to the back of the head and throughout the head to the forehead area.
Two courses of tension headache.
The tension headache can be episodic, that is, occasional, or chronic. A chronic tension headache is said to occur when the symptoms are prevalent on at least half the days in a month (15 days) or in a year (180 days).
Causes of tension headache
The causes of tension headache are not scientifically understood. The most common idea assumes muscular tension as the cause of tension headache. Treatment measures based on this show a good effect. Pain receptors are activated by a permanent tension of the neck and throat muscles, which triggers the headache. Due to the feeling of pain, the musculature tenses even more – a vicious circle develops. The muscles can become tense for a variety of reasons. Obvious are physical bad postures or a weakness of the back muscles. For example, an unfavorable body posture at work can lead to permanent discomfort.
Stress causes tension headaches
Some people also react during periods of stress by tightening the neck muscles. The proverbial weight “weighs on our shoulders.” Some scientists also believe tension headaches are related to orthodontic problems, such as grinding teeth at night.
What helps to relieve tension headaches?
Since the cause of tension headaches is often muscular pain, any measures to relax the muscles are beneficial:
- Heat, for example from a hot water bottle or a cherry pit bag, stimulates blood flow to the muscles and helps to remove metabolic products. The muscles can thus relax again.
- Essential oils, for example peppermint oil, have the same effect. They are applied evenly to the forehead, temples and neck.
- Also beneficial are massages.
Other home remedies for tension headache
In addition, there are so-called trigger points, which can bring relief according to the doctrine of acupressure: For this, gently massage your temples in circular motions, about two finger widths from the end of the eyebrows. A hot bath, alternating showers or sauna sessions also help to relax the muscles and have a stress-relieving effect at the same time. There is currently no scientific evidence for homeopathic remedies. If you are interested, ask a doctor with knowledge in the field of homeopathy for advice on which preparation might be suitable for you.
Caution with painkillers
Only if these general measures do not help should a painkiller be taken to relieve the tension headache. First-line agents are acetylsalicylic acid, ibuprofen, diclofenac, naproxen, or acetaminophen. Some preparations are available over the counter in pharmacies. If you have many pre-existing conditions or allergies, you should talk to your family doctor beforehand about a suitable painkiller. However, caution is advised with regard to the frequency of use: Especially for tension headaches, it is very important not to take the painkillers more than ten times a month.Otherwise, you run the risk of developing a drug-dependent headache, which is very difficult to treat. If you cannot control your tension headaches on your own, consult your doctor. If the symptoms persist for a long time, there is a risk of chronic tension headaches, the course of which is much worse due to the risk of developing a pain memory and accompanying psychiatric complaints.
The chronic tension headache
Chronic tension headache is rare and develops from episodic tension headache. Risk factors for a chronic course include secondary psychological disorders such as depression and anxiety disorders. Familial clustering of chronic tension headache has also been reported as a risk factor. If tension headache recurs constantly, the brain develops a so-called pain memory in the long term. Due to the frequent pain, pain regulation is disturbed and even small stimuli are increasingly perceived as severe pain. Especially chronic tension headache can therefore change the brain in the long run and should therefore be treated.
Special therapy for chronic tension headache.
Chronic tension headache is treated with medications that are also used to treat depression. Tricyclic antidepressants, such as amitriptyline or amitriptyline oxide, are first-line agents. They increase serotonin levels in the brain. Serotonin is a hormone that plays an important role in controlling sleep, mood and pain. Therapy with tricyclic antidepressants must be given over a long period of time to offer any chance of success. In addition, a headache diary should be kept. In this way, triggering moments in everyday life can be discovered and specifically counteracted.
When should you see a doctor?
In principle, tension headaches can be treated well with home remedies and general measures. However, if this cannot bring about an improvement, you should seek advice from your doctor. If the tension headache occurs very frequently and there is a suspicion of a chronic course, the consultation of a doctor is also recommended. Finally, there are some signs that may indicate other underlying diseases in connection with the tension headache. Contact a doctor if you have the following additional complaints:
- Visual disturbances
- Reduction in strength of the arms or legs
- Sensory disturbances, such as tingling sensations or numbness.
- Additional fever
- Neck stiffness
- Abrupt onset of headache
- Very severe headache
- Sensitivity to light and noise
- Nausea, vomiting
- Unilateral headache
- Redness and tearing of the eyes
- Headache after a fall
Preventive measures for tension headache.
Especially when there are signs of a chronic tension headache, preventive measures are recommended. Avoiding stress is important. This includes scheduling regular breaks in the workday and getting enough sleep. To become permanently symptom-free, the causes of muscular tension must be eliminated. A critical assessment of the workplace can already work wonders here. Attention should be paid, for example, to the height relation of table and chair, ergonomic arm and back rests, and the viewing angle of the monitor. Physical fitness is another important factor. Neurological professional societies recommend endurance sports such as cycling, swimming or jogging – preferably three times a week for 30 minutes.
Psychological stress in tension headaches
If you are in a stressful phase of life, conscious time out can help reduce stress and thus prevent tension headaches. Meditation, walks in the fresh air and relaxation exercises promise improvement. In the case of severe psychological stress, psychological treatment may even be necessary. Recognized methods include progressive muscle relaxation or biofeedback, supplemented by behavioral therapies.
