Solving tension headaches: causes and tips

Many different types of headaches are not symptoms of any other medical condition. These are called primary headaches. In neurology, they are divided into tension headaches, trigeminal autonomic headache disorders (e.g. cluster headaches), migraines and other primary headaches. Of these four forms, tension headache is the most common. Read about the symptoms, causes and treatment of this type of headache here.

Tension headaches: typical symptoms

A typical symptom of tension headaches is a dull, oppressive headache,  which rarely occurs on one side but mainly on both sides but cannot be localized precisely. “Like a band around your head” or “like a vice” are common descriptions of the symptoms. In addition, the following characteristics can often be observed in tension headaches:

• The intensity is light to moderate.
• The duration of the pain varies greatly and can range from a few hours to days.
• Slight nausea or sensitivity to light are rare.
• In contrast to other forms of headache, the pain does not worsen due to physical exertion, and there is no pulsation.
• Neck and throat muscles are often involved. The pain radiates from the neck to the back of the head and throughout the head to the forehead.

 

Two forms of tension headache

Tension headaches can occur episodically, i.e. occasionally or chronically, in those affected. One speaks of a chronic tension headache if the symptoms prevail for three months on at least half of the days of the month (15 days) or of the year (180 days).

Causes of tension headache

The causes of tension headaches have yet to be scientifically clarified. The most common idea assumes that muscular tension is one of the causes. Treatment measures based on this show a good effect.

Permanent tension in the neck and neck muscles could activate pain receptors, which triggers the oppressive headache. Due to the feeling of pain, the muscles tense up even more – a vicious circle is created.

This tension can arise for a variety of reasons. Poor physical posture or weakness in the back muscles are apparent. For example, an unfavourable posture at work can lead to permanent complaints. Other triggers, such as a lack of electrolytes from alcohol consumption or drafts, can also lead to tense muscles.

Some people also react to psychological complaints,  such as stress or anxiety, by tensing their neck muscles. The proverbial weight of negative feelings “hangs on our shoulders”. Tension headaches can also occur as part of depressive disorders.

Some researchers also believe there is a connection between tension headaches and orthodontic problems, such as teeth grinding at night. Malfunctions of the chewing and tongue muscles could also be a trigger.

 

Resolve tension headaches – what helps?

Since the cause of tension headaches is often muscular pain, any measures to relax the muscles are beneficial. This often succeeds in resolving the tension headache:

• Warmth, for example, from a hot-water bottle or a cherry stone bag, stimulates muscle circulation and helps remove metabolic products.
• Essential oils, such as peppermint oil, have the same effect. They are evenly applied to the forehead, temples and neck.
•  Massages,  for example, in the form of acupressure, are also beneficial.
• Specific neck exercises can help relieve tension headaches. For example, turn your head to the left and use your right hand to press lightly against your head at mouth level to intensify the stretch. Hold the position briefly and repeat the exercise on the other side.

Counteract mental stress

If you are in a stressful phase of life, conscious time-outs can help to reduce stress and thus counteract and prevent tension headaches. Meditation walks in the fresh air and relaxation exercises may prove helpful.

In the case of severe mental stress, psychological treatment may be necessary. Recognized methods are, for example, biofeedback or behavioural therapy, in which progressive muscle relaxation is often used.

Home remedies for tension headaches

According to the teachings of acupressure, there are also so-called trigger points that can bring relief. To do this, gently massage your temples in circular movements, about two fingers’ width from the end of your eyebrows.

A hot bath, contrast 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 homoeopathic remedies. If you are interested, ask a doctor with knowledge of homoeopathy for advice on which preparation might suit you.

 

Be careful with painkillers.

If these general measures do not help in a short period or if the headache worsens, a painkiller should be taken to relieve the tension headache. The drugs of first choice are Acetylsalicylic acid (ASA), Ibuprofen, or < /span> to active ingredients; you should consult a doctor before taking it. These preparations are available in pharmacies without a prescription. If you have previous illnesses or allergies, Paracetamol

However, caution is advised regarding how often they are taken. Especially for tension headaches, it is essential not to take the painkillers more than ten times a month and for no longer than three days in a row. Otherwise, you risk developing a medication-related headache, which is very difficult to treat.

If you cannot get your pain under control on your own, seek medical advice. If the symptoms persist for a long time, there is a risk of chronic tension headaches, the course of which is much more severe. The reason for this is the risk of forming a pain memory, i.e. the change and increased pain sensitivity of nerve fibres in the brain and accompanying psychological problems.

Chronic tension headache

Chronic tension headaches are rare and develop from episodic tension headaches. Risk factors for a chronic course are psychological illnesses such as depression and anxiety disorders. Chronic tension headaches that run in families are also reported as a risk factor.

If tension headaches keep recurring, the brain develops the previously mentioned pain memory in the long term. The frequent pain causes pain regulation in the brain to be disrupted, and even small stimuli are increasingly perceived as severe pain. Chronic headaches can change the brain long-term and should be treated.

Get rid of chronic tension headaches.

For chronic tension headaches, medications are used that are also used to treat depression. Tricyclic antidepressants, such as Amitriptyline, or tetracyclic medications, such as Mirtazapine, are Means of first choice. They increase the serotonin levels in the brain.

Serotonin is a hormone that plays a vital role in controlling sleep, mood and pain. Therapy with tricyclic or tetracyclic antidepressants must be carried out over a more extended period to offer any chance of success. In addition to these medications, the dual antidepressant Venlafaxine and the muscle relaxant tizanidine can also be used to treat chronic headaches.

In addition to drug treatment, biofeedback or relaxation therapy should also be used. There is also evidence of effectiveness in the treatment of chronic tension headaches through acupuncture.

In addition, a headache diary should be kept. In this way, triggering moments in everyday life can be discovered and counteracted in a targeted manner.

 

Cervicogenic headache, migraine or tension headache?

Some people who suffer from frequent headaches are unsure what type of headache it might be. This is particularly the case if the tension headache is accompanied by mild nausea and sensitivity to light, as is typical of a migraine attack. Involvement of the neck can also increase the risk of confusion.

In so-called cervicogenic headaches, the pain also extends from the neck to the forehead. However, these are usually unilateral and not bilateral. In addition, the pain worsens when the neck moves; the shoulder and arm can also be affected.

A few distinguishing features of migraines help differentiate them from tension headaches: The symptoms of tension headaches are usually mild to moderately intense, with migraines relatively moderately strong to very strong. In contrast to tension headaches, migraine headaches are usually one-sided, stabbing and pulsating. Vomiting or visual disturbances may occur.

Another important distinguishing feature is that if the headache worsens with movement, it is not a tension headache. Because these tend to improve with physical activity. In the case of migraines, however, the symptoms worsen in this case.

When should you seek medical advice?

Tension headaches can be treated well with home remedies and general measures. However, if this does not improve, you should seek medical advice.

If the tension headache occurs frequently and there is suspicion that it is chronic, consulting a doctor is also recommended.

Finally, some signs can indicate other underlying diseases connected to the headache. Seek medical advice if you have the following additional symptoms:

• Vision problems
• Reduced strength of the arms or legs
• Sensory disturbances, such as tingling or numbness
• additional fever
• Neck stiffness
• sudden onset of headaches
• very severe headache
• strong sensitivity to light and noise
• Nausea, vomiting
• one-sided headache
• Redness and tearing of the eyes
• Headache after a fall

Preventive measures for tension headaches

Preventive measures are recommended, especially if there are signs of chronic tension headaches.

Avoiding stress is essential. This includes planning regular breaks in everyday work, sufficient sleep, and a balance to the daily work.

To become permanently free of symptoms, you must eliminate the causes of the muscular tension. A critical assessment of the workplace can work wonders here. For example, attention should be paid to the height relation between table and chair, ergonomic armrests and backrests and the screen’s viewing angle.

Physical fitness is another important factor. Neurological societies recommend endurance sports such as cycling, swimming or jogging – preferably 30 minutes thrice weekly.