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Neurosciences and Behavioral Health Center

Tension Headache

Tension headache refers to radiating, steady pain in the head, neck or eyes that can be mild or intense. Tension headaches may be occasional or chronic and may result from teeth grinding and jaw clenching

 Tension headache: areas of pain. These include the upper back and neck, base of the head, around the ears, the jaw and above the eyes.
Tension Headache: Areas of Pain
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Tension headaches occur most commonly in women. Other factors that may increase your chance of getting a tension headache include:

  • Stress
  • Hunger
  • History of teeth grinding or jaw clenching
  • Anxiety
  • Depression
  • Sleep apnea or sleep disruption
  • Eyestrain
  • Poor posture
  • Injuries or arthritis of the neck area
  • Temporomandibular joint disease (TMJ)
  • Medications
  • Low physical activity
  • Obesity
  • Smoking

Tension Headache Symptoms

Some tension headaches are nearly constant, with daily pain that may vary in intensity, while others occur once in a while. Symptoms usually start slowly and build.

Tension headaches may cause:

  • Constant, steady pain and pressure
  • Dull and achy pain
  • Pain which may be felt on both sides of the head, in the forehead, temples and the back of the head
  • Pressure may feel like a tight band around the head
  • Intensity ranges from mild to severe and can vary during the day
  • Tightness in head and neck muscles

Headaches can become so severe and constant that they interfere with normal activities and sleep.

Tests that can diagnose your headache include:

  • Neurological exam
  • Imaging (CT or MRI) if needed

Managing Your Headache

There’s no cure for tension headaches. Therapies aim to stop the headache and reduce the frequency of future episodes.


For occasional headaches, your doctor may recommend:

  • Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain
  • Prescription pain relievers

Note: Pain medications are most effective when taken at the first sign of pain and before it becomes severe. Overusing some over-the-counter medications may actually cause headaches. Continuous use of medications may create rebound pain when you stop taking the drug.

For chronic headaches, your doctor may recommend the following to treat or prevent headaches:

  • Antidepressants
  • Muscle relaxers
  • Botulinum toxin injections (Botox)

Self-care During the Headache

Self-care may include:

  • Rest if needed
  • An ice pack or heat pack on your head or neck to ease discomfort
  • A warm shower, with water running over tense muscles

Lifestyle Changes

Lifestyle changes may include:

  • Regular exercise
  • Improving your posture
  • Adequate sleep
  • Regular breaks from tasks
  • Stress management and relaxation techniques
  • Counseling to:
    • Develop new coping skills
    • Identify events that trigger the headaches and work toward resolution

Additional Therapies 

Additional therapies may include:

  • Acupuncture — to have fewer headaches and lessen the intensity of headaches when they do occur
  • Physical therapy
  • Massage therapy


To help reduce your chances of getting a tension headache, try the following strategies:

  • Keep a diary, marking when headaches occur and what you were doing before they started.
  • Learn to recognize what provokes a tension headache.
  • Avoid or minimize stressful situations.
  • Take frequent breaks to walk or move around.
  • Make time for pleasurable activities.
  • Practice relaxation techniques, such as deep breathing and focusing on something pleasant.
  • Learn techniques for coping with difficult or stressful situations.
  • Make time for friends and build a strong support system.
  • Go to bed early and get a good night's sleep.
  • Exercise regularly.
  • Do not slouch.
  • Hold the phone, rather than cradling it on your shoulder, or use a headset.


Call 434.924.2706.


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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