The Tension Headache - A Modern Malady

When you feel like your head’s in a vise or has an ever-tightening c-clamp around it, the torture chamber you’ve encountered is a tension headache.

The tension headache is the most common type of primary headache (a primary headache is one that has no underlying cause like a brain tumor!) Tension headaches are often characterized by muscular tenderness. Along with soreness in the neck, shoulders, arms, face, and at the base of the skull, they may even cause the scalp and forehead to be sore to the touch. So, when the headache is so bad that your “hair hurts”, you most likely have a tension headache. A tension headache can hurt so much that it causes you to clench your teeth, which probably contributes to the pain rather than helping it to subside. Another characteristic of tension headaches is that they usually attack both sides of your head at the same time.

There are two classifications of tension headache. The episodic headache is a recurring headache that can last from half an hour to a week. They generally occur less than 15 times a month and usually respond well to pain relievers like aspirin, acetaminophin, and ibuprofen. The chronic tension headache is the type that occurs more than 15 times a month. Although chronic headaches share many of the same characteristics as the episodic headache, in addition those who suffer from chronic tension headaches may also experience nausea, vomiting, and/or sensitivity to light or noise. Moreover, chronic tension headaches frequently do not respond to medication.

Current estimates are that 75% to 90% of all chronic headache patients suffer from tension headaches. Because they share some of the same characteristics as the migraine, some physicians believe that they are the same type of headache at different ends of the spectrum. Certain tendencies of both of these headaches support this belief. Both chronic tension headaches and migraines are more prevalent in women than in men. Generally, migraines start sometime after age 10 and dissipate during middle age, where as chronic tension headaches usually start during mid-life. In addition, like the migraine sufferer, some victims of the chronic tension headache report that at times their head seems to pulsate with the pain . Although doctors call this a tension-vascular headache, it indicates another area where migraines and chronic tension headaches seem to overlap.

For those who do try to treat tension headaches with over-the-counter medication, care should be taken to avoid overuse since “too much of a good thing” can lead to severe “rebound headaches”. Some people also report some success at both preventing and relieving tension headaches with alternative therapies such as massage, acupuncture, and biofeedback techniques. Since tension headaches are often the product of environmental stress and anxieties, psychotherapy is often successful in helping to cure the chronic tension headache. An effective prescription drug for treating tension headache is amitriptyline. Amitriptyline is also an effective antidepressant and may improve the anxiety commonly associated with tension headaches.