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Tension Headaches

What are Tension Headaches?
A tension headache is the common term used to describe muscle contraction headaches. Pain can be sharp, burning or throbbing at times. The headaches frequently cause a tightness or "band-like" sensation around the head. The headaches can also localize in the forehead, temple or in the back of the head and neck. The pain can stay for hours, days or even weeks at a time.

What Causes Tension Headaches?
The mechanism of pain involves a tightening of the muscles which support the spine and skull. There are facial muscles which can be a source of pain also. Various factors can trigger tension headaches. The most common sources are cervical (neck) arthritis or cervical strain (injury to the soft tissue of the neck including muscles and ligaments). Often muscles will contract to "splint" the area and keep the injured tissue from making painful movements. Poor posture or prolonged use of muscles can trigger tension headaches. Holding the head or neck in a stiff or awkward position for a period of time can bring on a tension headache.

Emotions have a great impact on triggering tension headaches. Just as our muscles contract in response to physical pain, they will also contract in response to emotional pain. Worry, fear, unexpressed anger and anxiety can all contribute to tension headaches.

Sleep problems such as difficulty falling asleep or waking up frequently often occur with tension headaches. Depression also is very common.

How are Tension Headaches Diagnosed and Treated?
The diagnosis of a tension headache is usually based on the patient's history and physical examination. A thorough neurological examination is necessary to rule out other causes of headaches. Occasionally diagnostic testing such as X-rays, CT scans or MRI scans are done.

In treating tension headaches, it is important to alleviate the discomfort, attempt to discover and modify or eliminate trigger factors and to increase the patient's understanding of the physical process of the headache.

Medication often is used to treat tension headaches. The type of medication depends on the frequency of the headaches and other associated symptoms. Non medication therapy also is very useful in treating tension headaches. Physical therapy, biofeedback, acupuncture and other treatment methods are used with good success.

Minnesota Headache Center
A service of Noran Neurology