Tension Headache

Written by Dr. Jason Ngan, DC

What is a Tension Headache?

Tension headache or tension-type headache (TTH) are the most common forms of headaches. TTH account for ~38% of all headaches in adults. TTH are usually mild to moderate in intensity and can be treated with non-invasive therapies and healthy lifestyle changes. There are two types of TTH, episodic and chronic. Episodic TTH last for 30 min to 1 week and occurs less than half the month in a 3 month times span. Chronic TTH last continuously for hours and occur more than half the month over 3 or more months.

What Causes Tension Headache?

The exact cause of TTH are unknown. TTH can originate from trigger points, tight muscles in the neck, face, and scalp. Newer research suggests TTH can be caused by abnormal changes in brain chemicals (neurotransmitters). Some contributing factors include stress, anxiety, poor posture, fatigue, eyestrain, and jaw clenching.

What are the Signs and Symptoms?

  • Tight band feeling around the forehead area

  • Pain occurs on both sides of the head

  • Pain worsens as the day goes on and peaks in the early evening

How is Tension Headache Diagnosed?

TTH is diagnosed with a thorough medical history, physical examination, and orthopedic testing.

  • Pain quality, location, and intensity can help with diagnosis.

  • Diagnostic imaging such as x-ray, CT, or MRI are not used to diagnose TTH but they can be used to rule out other pathologies.

What are the Treatment Options?

Headache types are often misdiagnosed. At Ngan Chiropractic, we carefully investigate the cause of the headache and treat appropirately. Chiropractic care is highly effective at treating tension headaches. Some options we provide are:

  • Chiropractic manipulation and mobilization

  • Flexion-distraction

  • Spinal traction

  • Soft tissue therapies

  • Gua-sha

  • Cupping

  • E-stim

  • Ergonomic/postural/sleep counseling

  • Rehabilitative exercises and stretching

  • Stress management

Other treatments that patients may seek (not provided at Ngan Chiropractic) include acupuncture and pain medication.  However, repeated use of pain relief medication can cause other types of headaches.

References

  1. Chowdhury D. Tension type headache. Ann Indian Acad Neurol. 2012 Aug;15(Suppl 1):S83-8. doi: 10.4103/0972-2327.100023. PMID: 23024570; PMCID: PMC3444224.

  2. Chu ECP, Ng M. Long-term relief from tension-type headache and major depression following chiropractic treatment. J Family Med Prim Care. 2018 May-Jun;7(3):629-631. doi: 10.4103/jfmpc.jfmpc_68_18. PMID: 30112321; PMCID: PMC6069670.

  3. Hassan, M., Asaad, T. Tension-type headache, its relation to stress, and how to relieve it by cryotherapy among academic students. Middle East Curr Psychiatry 27, 20 (2020). https://doi.org/10.1186/s43045-020-00030-3

  4. Pluta RM, Lynm C, Golub RM. Tension-Type Headache. JAMA. 2011;306(4):450. doi:10.1001/jama.2011.886

  5. Shah N, Hameed S. Muscle Contraction Tension Headache. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562274/

  6. Zhou, Jun MD; Cheng, Shirui PhD; Yang, Han MD; Lan, Lei PhD; Chen, Yijia BD; Xu, Guixing MD; Yin, Zihan MD; Li, Zhengjie PhD; Liu, Mailan PhD. The brain structure and function alterations in tension-type headache: A protocol for systematic review and meta analysis. Medicine 99(24):p e20411, June 12, 2020. | DOI: 10.1097/MD.0000000000020411