What it is a tension type headache?
A Tension type Headache is the most common headache, accounts for 90% of all headaches and is responsible for over 50% of patient’s that attend a GP with headache related pain. Tension type headache is the medical term used to describe those normal back ground headaches that we experience from day to day. 3% of the population is unfortunate enough to experience a chronic version of the tension type headache that occurs unrelenting for over 15 days of a month normally consecutive and can last for 6 months duration or even longer. Typically a tension type headache will feel like a constant throbbing or aching pressure with pain radiating around the top of the forehead, temples, side of the head and around into the base of the skull often also affecting the upper neck. Patients commonly describe this as a feeling of a really tight band stretched around squeezing the head or as feeling like their head is stuck in a vice. In these cases people’s natural instinct is to message their temples.
What does a tension headache feel like?
A tension type headache, be it chronic or not is usually a mild to moderate headache only occasionally being reported as severe and normally then when there is an underlying migraine to blame. The tight band is a constant dull ache, felt equally on both sides of the head. The dull ache normally starts at the base of the skull or in the forehead and then begins to gradually radiate round into the tight band. In a lot of cases discomfort, stiffness and muscles spasms are experienced in the neck and upper shoulders. The constant ache can be very distracting and can lead to very poor concentration levels. Tension type headaches aren’t usually aggravated by any particular movements or postures. If additional symptoms like light or noise sensitivity, nausea, vomiting or flashing lights are developed then the headache is more likely to be diagnosed as a migraine.
Why & when does a tension headache happen?
The exact reason why a tension headache develops is not completely understood yet however key factors that precipitate a Tension type headache have been identified. Stress is a common factor in particularly after long hours of working in a pressurized environment to meet deadlines or under exam revision or indeed after the hours of concentration during the exam itself. The awkward posture that your body holds after hours of working at a desk also doesn’t help by adding stress and strain onto the neck and upper shoulder muscles. Teeth clenching or teeth grinding which is often done during your sleep when you are very tired and stressed has been recognised as initiating a tension type headache.
Sleep deprivation is considered a trigger factor as is poor eating habits, dehydration and excess alcohol intake. In many cases there is intolerance or an overload of a certain food type to blame, caffeine being the most common example. Another common issue is seen in people wearing the incorrect lens prescription or in people who need glasses. The resultant eyestrain can often trigger a tension type headache. Normal episodes of tension type headaches are four times more likely to be experienced by women whereas twice as many men suffer with the chronic version of the headache. The affected age group is normally in early 20’s or 30’s with it being rare to have your first Tension type headache diagnosed after the age of 50.
How long does a tension headache take to heal?
Tension type Headaches can last for anything from a couple of hours up to a day and can occur daily although most commonly last for 4-6 hours. Normally the headache will last on and off until the causative factor has been amended. Tension type headaches that occur for over 15 consecutive days within a month are classed as Chronic Tension type headaches. The duration of chronic tension type headache is over 6 months and in some cases lasting up to five years.
How will a tension headache be diagnosed?
Your GP or therapist will be able to diagnose you by taking a full history of your headache symptoms including when they start, how long they last for, where exactly do you feel the headache and what activities normally pre-empt the headache. Most importantly the GP will ask you whether you experience any additional symptoms like flashing lights, nausea or vomiting, dizziness and many more this is to rule out migraines or headaches caused by other conditions in the body. This is extremely important as it determines whether any extra tests or investigations are needed. The GP or therapist will examine your neck, shoulders and upper back to check for any muscular tension or joint stiffness. This will dictate what type of treatment is prescribed. No X-rays or further investigation should be needed to confirm the diagnosis.
What treatments are available for tension headaches?
Your GP may prescribe a short course of anti-inflammatory painkillers like ibuprofen or Paracetamol as prescribing a codeine based painkiller may worsen or trigger a medication overuse headache. Applying a covered ice or heat pack to the neck or upper shoulders may help to relax any muscular strain or spasm.
The only way to really treat or even prevent a Tension type headache is to identify and avoid the trigger factor. Many people find manipulative therapies such as chiropractic, osteopathy or physiotherapy to be helpful in alleviating any neck, shoulder and upper back tension. Some people also find acupuncture very helpful to alleviate the tight band sensation. Massage therapies and therapies like Bowen technique are very good at reducing the muscular tension and alleviating the pressure around the neck and shoulders. Postural therapies like Alexander Technique is effective for teaching your body how to hold a good posture as is Pilates and Yoga for strengthening your postural muscles. Your therapist or GP will be able to advise you on when it is appropriate to start and what exercises you should concentrate on. Getting your eyes tested or re-tested to check your lens prescription is correct will eliminate that as a cause factor. For office worker or drivers alike it is extremely important to take a good look at your work station ergonomics. That means for drivers, ensuring that they are sitting at the right height and distance from the wheel and for office workers, making sure that your computer screen is at the right height and distance from your eye line and adjusting your chair to the right height. This will allow you to avoid the awkward posture that can cause muscular tension. It is vital to take a look at your diet and also at your eating habits ensuring that you are eating at regular intervals and drinking enough fluids. If this is a concern then it is advisable to consult a dietician or nutritionist who can examine your daily diet and suggest where and what improvements you could make.