What is a tension headache?

A tension headache is a mild or moderate headache that feels like tightness or pressure around your head.

They are very common — almost everyone will have a tension headache at some point. Some people have chronic tension headaches, with symptoms on most days.

What symptoms are related to tension headache?

Tension headaches usually cause pain on both sides of your head. Your neck and shoulders may also feel sore.

You might feel:

• a constant dull ache in your head
• like something is pressing down on top of your head
• a pressure or tightness forming a band around your head

You might also feel sensitive to light or sound.

A tension headache doesn't get worse with movement, but it may get worse over the course of the day. It might go away after half an hour or so, but it can last for up to a week.

What causes tension headaches?

Doctors don't know exactly what causes tension headaches. It is thought to be a combination of genetics, biological and environmental factors.

These headaches are not caused by muscle contractions, but muscle tension can make the pain worse.

Other triggers for tension headaches include:

• feeling stressed, anxious or depressed
• lack of sleep
• poor posture at work, home or when driving
• bright, noisy environments
• eye strain from long periods of reading or screen use
• smoking
• dehydration or withdrawal from caffeine

The overuse of pain-relief medicines has also been shown to cause tension headaches.

How is the cause of tension headaches diagnosed?

Your doctor will diagnose tension headaches by talking to you and examining you. There is no specific test for tension headaches.

Keeping a headache diary can help you understand what triggers your headaches. There are many resources to help you keep a headache diary.

Your diary should record:

• the number of days you have a headache
• how severe your headache is
• any other symptoms associated with your headache
• any potential triggers

If your pain doesn't go away, your doctor may do tests to check for other causes of headache.

Your doctor may refer you to a neurologist — a specialist doctor who diagnoses and treats conditions of the brain, spinal cord and nerves.

When should I see my doctor?

If you get severe headaches, see a doctor to work out what's causing them and how to treat them.

See your doctor if your headaches:

• are more frequent or more severe than usual
• prevent you from working, sleeping or participating in normal activities
• mean that you take pain-relieving medicines more than twice a week

When to seek urgent care

In some cases, headaches can be a symptom of something more serious. See your doctor straight away if you experience a:

• severe headache that begins suddenly
• headache that gets progressively worse over several weeks
• morning headache with nausea that doesn't go away
• headache that starts after an injury to your head
• headache that gets worse when you are lying down
• headache that starts when you cough

If you are pregnant and have a headache that begins suddenly or is different to your past headaches, speak to your doctor.

• fever
• vomiting
• neck stiffness
• confusion or a change in personality
• blurred or double vision
• loss of balance
• a seizure

How are tension headaches treated?

Although there is no complete cure for a tension headache, there are several helpful treatment options to reduce the pain and how long your headache lasts.

Self-care at home

You can relieve your tension headaches by:

• resting
• applying a heat pack
• massaging your neck
• drinking water, if you haven't had enough to drink
• trying acupuncture or physiotherapy

Medicines for tension headache

You can reduce the pain from tension headaches by taking over-the-counter pain-relief medicines, such as paracetamol, ibuprofen or aspirin. Tablets containing pain-relief medicine combined with caffeine can work especially well.

See your doctor or pharmacist before taking over-the-counter pain relief if you are taking any other medicines, have allergies or are planning surgery.

Make sure not to take pain-relieving medicines more than 2 or 3 times a week — this could make your headache worse and harder to treat.

Your doctor might prescribe you a preventive medicine to reduce how often you get a tension headache. Your doctor may prescribe an antidepressant to take regularly to help control your headaches.

Read more on medicines for headaches.

Other treatment options

If you get tension headaches often, stress management techniques can help. You might want to try:

• yoga or meditation
• biofeedback training
• cognitive behavioural therapy (CBT)
• physiotherapy
• regular exercise

Try to identify any triggers that cause your tension headaches and make lifestyle changes to manage them. This may include:

• stress
• dehydration
• lack of sleep
• too much or too little caffeine

What are the complications of tension headaches?

Taking pain-relieving medicines for a long period of time can cause complications including:

• medication overuse headaches
• kidney and liver problems
• stomach ulcers
• higher chance of cardiovascular disease

Talk to your doctor if you take medicine often to help treat tension headaches.

Can tension headaches be prevented?

You can prevent tension headaches by making healthy lifestyle changes:

• Take time for relaxation and stress management techniques.
• Drink plenty of water.
• Get regular exercise.
• Get enough sleep.
• Eat a healthy, balanced diet.
• Improve your posture.

Resources and support

Visit Migraine & Headache Australia to learn more about headaches and to join an online support group.

Check out the ANZ Headache Society for helpful tips to manage headache.

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Languages other than English

The Pain Management Network has translated resources in many community languages.