Andrew Gallagher

Tension headaches are amongst the most common types of headaches.  Characterized by a dull, aching sensation that can range from mild to severe, they often occur as a result of stress, fatigue or muscle tension and can affect individuals of all ages. In understanding the complexities of tension headaches, it is essential to explore their causes, how they are diagnosed and the various treatment options, including medication and exercise.

Causes of tension Headaches

While the exact cause of tension headaches is not fully understood, several factors are believed to contribute to their development:

  • Muscle Tension: Physical tension in muscles of the neck shoulder scalp and jaw can trigger headaches. Poor posture, long periods of sitting and cumulative strain from repetitive tasks such as typing can contribute to muscle stiffness and, over time, areas of hyper sensitivity in muscles (trigger points) can develop leading to a chronic cycle of reoccurring headaches.
  • Stress and anxiety: Emotional distress is a significant contributor to tension headaches. Situations that involve high levels of stress, such as work-related pressures, family issues or financial concerns can lead to tightening of muscles in the head neck and shoulders.
  • Fatigue: Lack of sleep or overall fatigue can increase the likelihood of experiencing tension headaches. When fatigued, muscles are more prone to suboptimal function increasing the likelihood of increased muscle tension leading to headaches.
  • Dehydration: Not drinking enough water can contribute to headaches. Dehydration can cause the brain to temporarily shrink from fluid loss, triggering pain.
  • Caffeine Withdrawal: For individuals who regularly consume caffeine, sudden withdrawal can lead to headaches. Tension headaches can occur when the body craves a substance it has relied upon.
  • Eye Strain: Excessive screen time, uncorrected vision problems ,or poor lighting can lead to eye strain which is another potential trigger for tension headaches.

Diagnosis of Tension Headaches

  • Medical History: A healthcare provider will begin by taking a comprehensive medical history, asking about the patient’s headache frequency, duration intensity, associated symptoms and any potential triggers.
  • Physical Examination: A physical examination is undertaken to assess muscle tension and evaluate the individual’s posture.
  • Neurological Examination: In some cases, further tests may be warranted to rule out other types of headaches or neurological conditions. This may include imaging studies, such as a CT or MRI scan, though such imaging is rarely needed for typical tension headaches.

Treatment of Tension Headaches

Effective treatment for tension headaches is multifaceted, incorporating medication, lifestyle changes and various exercises.

  • Medication:
    • Over the counter medications such as Panadol, ibuprofen and naproxen are effective for mild to moderate headaches and are generally well tolerated with minimal side effects.
    • Prescription Medications: For more severe or frequent headaches, prescription medications may be required these can include muscle relaxants to help relieve tension, particularly in situations of acute or severe tension headaches, but are not recommended for long term use.
    • Antidepressants: Certain types of antidepressants such as amitriptyline ( Endep) can help modulate   the pain experience associated with chronic tension headaches, as well underlying anxiety which is often a contributing factor.
  • Lifestyle Changes: Implementing lifestyle modifications can significantly reduce the frequency and severity of tension headaches.
  • Stress Management Techniques: Yoga, meditation, and deep breathing exercises can help reduce stress levels.
  • Regular Physical Activity: Engaging in regular exercises, including specific muscle stretching techniques, can normalise muscle tone and assist in stress management.
  • Ergonomic Adjustments: Improving  work posture during work or recreational activities, particularly while at the computer will help alleviate  muscle strain.
  • Adequate  Hydration: Ensuring sufficient intake throughout the day can help prevent dehydration- related headaches.
  • Exercises for Relief: Integrating specific exercises into a daily routine can greatly aid in relieving tension headaches.
    • Neck Stretches: Gentle stretching can help relax tight muscles. For example, gently tilting your head to one side, holding for about 15-30 seconds, and then changing sides can provide relief.
    • Shoulder Rolls: sitting or standing, roll your shoulder forward and backward in a circular motion to decrease tension.
    • Chin Tucks: by sitting or standing upright, gently tucking your chin toward your chest, holding for a few seconds. This exercise strengthens neck muscles and improves posture.
    • Aerobic Exercise: Activities such as walking, swimming or cycling can promote endorphin release and reduce stress levels.

Conclusion

Tension headaches can significantly impact an individual’s quality of life. Understanding their causes, seeking appropriate diagnosis, and implementing effective treatment strategies ranging from medications to lifestyle and exercise interventions can markedly improve outcomes. If headaches persist or worsen, it is essential to consult with a health care professional for personalised advice, tailored to individual needs. By adopting proactive measures, relief from the pain associated with tension headaches can be readily achieved enabling individuals to reclaim their daily activities.

Andrew Gallagher is an experienced physiotherapist working locally at Springs Medical in Daylesford . He has a special interest in head neck and jaw pain.