What Is A Tension Headache: Medication, Relief And Symptoms

What Is A Tension Headache?

Tension headache, or tension-type headache, is a mild to moderate pain around the head. Tension headaches often feel like a constricting band around the head, akin to a tight, vice-like grip. According to the American Migraine Foundation, they are the most common type of headache, affecting three-quarters of the general population. Tension headaches are common headaches that people often mistake migraine for.

There are 2 types of tension headaches: episodic and chronic.

Episodic Tension Headache And Treatment

Episodic tension headaches are defined as headaches that last from 30 minutes to a week. However, that is just a rule of thumb. Sometimes, episodic tension-type headaches can occur less than 15 days a month for at least three months. While episodic tension headaches are quite common (and can be easily treated), frequent episodic tension-type headaches may become chronic. Episodic tension headache treatment often involves healthy lifestyle habits, such as managing stress, having a healthy diet and so on. However, you may have to resort to over the counter (OTC) medication prescription but that isn’t necessary all the time.

Chronic Tension Headache And Treatment

Unlike episodic tension headaches, chronic tension headaches may last continuously for hours. If your headaches occur 15 or more days a month for at least three months, they can be defined as chronic. Chronic tension headache treatment may include painkillers, like aspirin, ibuprofen, paracetemol, or tylenol.

Tension Headache Symptoms

You might be wondering, “Which symptom is most indicative of a tension headache?” Some of the signs and symptoms of a tension-type headache include:

• Dull, aching head pain
• Tightness or pressure on the sides and back of head, or across the forehead
• Tenderness in the neck, scalp, and shoulder muscles

Tension Headache Treatment

You may attempt to find some relief by yourself when you experience tension headaches. However, you may develop a type of headache called medication overuse headache when you use non-prescription painkillers too much. Thankfully, there are various tension headache medications that can help alleviate tension headache pain. The medications are classified as acute and preventive tension headache medication.

Making sure you eat well is important in mitigating tension headache symptoms. This means not abstaining from food over a long period of time and taking the right supplements, such as magnesium supplements for migraine symptoms etc.

Acute Tension Headache Medication

Here are some common acute tension headache medications:

• Painkillers: Ibuprofen, aspirin, and naproxen sodium (Aleve). Ibuprofen comes in the form of Advil Migraine, Motrin IB etc. These are medications you can find at home, without the need for prescription medication for tension headaches. If you are still looking for relief, Excedrin Tension Headache is an available medication you can consider. Excedrin Tension Headache provides fast relief for tension headache.
• Combination medication: Aspirin or acetaminophen (Panadol or Tylenol) or both are often combined with caffeine or a sedative drug in one kind of medication. This is similar to the idea of a migraine cocktail where multiple tension headache medication can provide faster relief.
• Triptans: For episodic or chronic headaches, triptans can provide relief. Opioids are rarely used due to the possibility of dependency, or worse, addiction.

Knowing the best medication for tension headaches will depend on the pain location of the tension headache. Other factors will include the intensity of the tension headache pain, the frequency of the tension-type headache etc.

You may have heard of anti-CGRP or CGRP inhibitors medication. While they are helpful for migraine attack treatment, some of CGRP inhibitors like Ubrelvy do not work on tension headaches.

The same applies if you are looking for chronic tension headache treatment. Sometimes, popping painkillers can help provide some relief. However, you may need to visit the emergency room (ER) for chronic tension headache treatment if the frequency and intensity of the tension headache is too unbearable. They may administer medications similar to a migraine cocktail in ER.

Preventive Tension Headache Medication

Tricyclic antidepressants such as amitriptyline and protriptyline are frequently prescribed medications for the prevention of tension headaches. However, potential side effects of amitriptyline include:

• Constipation
• Drowsiness
• Dry mouth

There is also evidence supporting the use of other antidepressants like venlafaxine (Effexor XR) and mirtazapine (Remeron) for this purpose. Additionally, anticonvulsants and muscle relaxants like gabapentin and topiramate (Topamax, Qsymia, among others) may be helpful in preventing tension headaches, although more research is necessary to confirm their efficacy. Some common side effects with venlafaxine include:

• Nausea
• Dry mouth
• Hot flushes or profuse sweating

Tension Headache Exercises

Some tension headache exercises you can try include neck flexion stretch, upper trapezius stretch etc. They are easy to try at home. Also, they are similar to exercises for cervicogenic headaches.

Finding Tension Headache Relief

Tension headache relief may be found more easily than a migraine attack. Because the severity is less, tools for relief may have a bigger impact sooner. Understanding in advance and being prepared for tension headaches will help you respond quicker, potentially lessening the severity and duration and relieving the tension headache. One of the ways you can find tension headache relief is to have your very own headache toolbox!

First, reflect on actions, medications and tools that have helped provide relief in the
past. Second, consider adding some of the following:

• Ice roller: Store the roller in the freezer and use it to roll across the temple
• Migraine cap: Gel packs in the cap freeze and the cap is stored in the freezer;
  use for all over relief
• Rice/lavender/buckwheat pack: Use a pack that can be heated in the microwave
  and laid across the temple, around the neck or on the shoulders
• Massage ball: Use a small massage ball (or even a tennis ball) to roll across
  shoulders, the temple or down the neck while up against a wall
• Migraine pillow: Having the best pillow for tension headaches can help provide some relief and rest without aggravating the tension headache!

Third, find a convenient storage container (this can be as simple as a shoe box or an
acrylic organizer box) to keep your tools inside. Be sure to keep your preferred tension headache medications, from ibuprofen to Aleve, Naproxen or Excedrin for tension headaches!

Finally, put pen to paper (or type up and print out a list) and enumerate all of the tools in
your toolbox, along with actions or steps you can take, such as:
– Hydrate: Immediately increase water consumption
– Caffeine: For some people, a caffeine + Excedrin combo can provide quick relief
– Take a walk: Fresh air and big movement calms the nervous system
– Take a nap: A quick 20-minute nap after taking medication has proven to be
effective in quicker headache resolution (be sure to set a timer)
– Stretch: Take a few minutes to stretch tense neck and shoulder muscles
– Schedule a massage or chiropractic visit

Once you’ve assembled your toolbox, keep it in a convenient place so you’ll remember
to access it and use the tools you’ve gathered and identified. With all these different ways to get rid of tension headaches, you will be able to find your own “sweet spot” in terms of tension headache relief.

Tension Headache Relief (Pressure Points Massage)

There are also some helpful tension headache relief pressure points that you can try massaging for tension headache relief. Some of them include the Union Valley (between thumb and index finger), Drilling Bamboo (indentations on both sides of the spot where your nose bridge meets your eyebrows’ ridge) etc. Knowing these tension headache relief pressure points will be helpful as tension headache relief massages can be self-administered.

Tension Headache Relief Foods

Having a healthy diet is beneficial as a preventive and acute way of providing tension headache relief. Some tension headache relief foods include:

• Green leafy vegetables, like kale and spinach are high in vitamins, minerals, and antioxidants. Antioxidants are compounds that help reduce oxidative stress in the cells and fight against free radical damage
• Fruits, like strawberries, blueberries are also high in antioxidants
• Root vegetables, like potatoes and beetroot are also considered tension headache relief foods

These foods do not just provide tension headache relief. They are also helpful for people who suffer from migraine. Research has shown that having a healthy diet can help relieve migraine attack symptoms.

How Is A Tension Headache Different From Migraine?

Occasionally, we will hear some well-intentioned, yet misguided people tell us certain things that betray their ignorance of what migraine is, like..

“Migraine is JUST a headache, no??”

Most of the time, we will just sigh at their ignorance. Our reaction might even be more visceral: we feel a surge of incredulity and annoyance coursing through our veins. We WISH someone would educate them.

Firstly, it’s important to remember that migraine is a neurological disease, whereas a tension headache is often just an episodic symptom. We may alleviate the pain of a tension headache with common over-the-counter (OTC) medication like Tylenol, but there is currently no cure for migraine and finding an effective relief method for a migraine attack is not as easy as simply popping a pill.

In terms of severity, duration, physical, mental impact, migraine attacks are often more debilitating than tension headaches. This is because migraine attacks also often come with nausea and vomiting, even though the pain may feel similar to a tension headache. Even so, the pain of most tension headaches is usually not severe enough to inhibit physical activity. 

A final, important step you can take is tracking your headaches. From tension headaches to migraine attacks, Migraine Buddy helps you note duration, severity, time and place – and track what you used in your toolbox that did or didn’t help. When the next tension headache comes up, grab that toolbox and the Migraine Buddy app for quick and easy direction on what to do for relief.

This article is written by Susan Bassett, one of our amazing #MBvolunteers. If you would like to make a difference in the migraine community, join us here!