A tension headache is the most common form of a primary headache. It happens intermittently in up to 80% of the population. As the symptoms are not as severe as a migraine, tension headache is only considered a problem if it becomes frequent or long-term. The symptoms include pain behind the eyes, in the neck and head, particularly the forehead, and is often described as feeling like a tight band wrapping around the head. It is believed that muscle tension, the central nervous system (nerves and chemicals in the brain), and changes in the blood vessels, may all play a role.
WHAT ARE THE SYMPTOMS OF A TENSION HEADACHE?
Frequent tension headache is recognised when you experience at least 10 headaches in a one month period. There are varying degrees of frequency and chronicity. Chronic tension headache sufferers report headaches on more than 180 days in a year. The symptoms include:
pain on both sides of the head, across the temples, over the eyes and forehead and wrapping around the head
pressing or tightening in nature
mild to moderate intensity (and will not tend to interrupt or inhibit your ability to work or continue daily activities). Tension headache sufferers can experience symptoms associated with migraine such as nausea and a hypersensitivity to light and noise, but usually only one of these symptoms
WHAT TRIGGERS A TENSION HEADACHE?
Poor posture - including desk, computer work, work space environment, and sleeping position
Long periods looking at screens
Eye stress, related to poor vision not being corrected with lenses or eye stress from blue light rays from screens
Fatigue
Drop in blood sugar, not eating at regular intervals
Although tension headaches, as the name suggests, are frequently triggered or aggravated by stress, they can also stem from poor nutrition, fatigue, insufficient sleep, alcohol use, hormonal fluctuations, and weather changes.
HOW IS A TENSION HEADACHE DIAGNOSED?
There is no one specific test that identifies tension-type headache. Your diagnosis will be made based on your symptoms and how you respond to different treatments. If you keep a headache diary this will help your healthcare practitioner determine any patterns or identify any triggers which can help in diagnosing the type of headache you have and advise you on how to prevent them.
HOW CAN PHYSICAL THERAPY AND MASSAGE HELP YOU?
Physical therapy including massage to the neck, can be very quick and effective at relieving your tension headache through relaxation of muscles which are under excessive tension or in spasm. It is important to remember that excessive muscle tension will compress, distort or irritate joint structures, including nerves, that can cause cervicogenic headaches (headaches originating from a dysfunction in your neck) which will further complicate your symptoms. Your tension headache treatment may include all or some of the following techniques:
Stiff neck joints may need to be loosened or unlocked via joint mobilisation (gentle gliding techniques), joint traction or in specific cases a gentle and localised joint manipulation technique.
Hypermobile (or dynamically unstable) joints may require specific deep neck muscle strengthening exercises to stabilise, control and limit the joint movement available.
Tight or overactive muscles may require stretching, massage, acupuncture, dry needling, or other relaxation techniques.
Weak muscles may require specific strengthening exercises. This may include your postural shoulder blade and neck muscles.
Nerve dysfunction may be addressed by your physical therapist depending upon your specific examination findings. Nerve sensitivity is a common finding associated with neck conditions, tension and muscle spasm as well as poor posture. Specific treatment and home stretches can improve nerve mobility or reduce nerve irritation.
Posture correction may be recommended via specific exercises, posture awareness techniques, taping or a posture brace.
HOW CAN YOU AVOID TRIGGERING A TENSION HEADACHE?
Take regular breaks from sustained postures and screen time.
Correct your posture at work with advice from your physical therapist about correct seat, desk and computer height.
Change your sleeping position and pillows to ensure good alignment in bed, your physical therapist can help with this.
Learn relaxation techniques, meditation, mindfulness, deep breathing techniques which you can do throughout the day to relieve tension.
Regular massage will relief from stress and tension and maintain good mobility and muscle length avoiding the build-up of muscle spasm in your upper back and neck. Massage promotes the release of endorphins – happy hormones – which are proven to reduce stress. Regular physical activity or exercise is excellent in relieving stress and mobilising or strengthening muscles and joints. Exercise has also been proven to release endorphins which can relieve stress and trigger a positive feeling in your body.
Attend yoga or Tai Chi classes to relieve stress.
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