Last time, we discussed migraine headaches and the various “auras” and other symptoms they cause. The most common type of headache you’ll see in good times or bad, however, is the plain ol’ tension headache. Eighty percent of the general population gets them from time to time.
Tension headaches feel like your head got caught in a vise. Also called stress headaches, they don’t incapacitate you like migraines can, but certainly affect your quality of life and, in survival settings, your all-important work efficiency.
TYPES OF TENSION HEADACHES
Generally speaking, two types of tension headaches are recognized: episodic and chronic. Both are conditions that last more than three months, but episodic tension headaches happen less than 15 days a month, while chronic headaches are more often. As a matter of fact, those with the chronic type often describe it as “just about always there.”
Both types can last 30 minutes to several days. It’s thought that the episodic types are shorter and start more slowly, most often in the middle of the day.
CAUSES OF TENSION HEADACHES
Although the cause of tension headaches hasn’t been established definitively, they may be caused by spasms of the muscles of the neck and head, anxiety, abnormal posture, or any of a number of other issues. Many now believe that differences in how a person’s brain processes pain signals may also play a role.
In any case, stress caused by anxiety and/or depression usually appears to be the initiating factor. Other triggers related to survival scenarios include lack of rest, fatigue, hunger, and dehydration. In normal times, abuse of substances like alcohol, dental problems, eye strain, and even poor posture may plau a role. Of course, illnesses like respiratory infections can also be triggers.
SYMPTOMS OF TENSION HEADACHES
You can expect the patient to complain of are dull pressure pains in the back of the head, neck, and shoulders, often on both sides. The temples and frontal areas can also be involved, however. You may see irritability, fatigue, trouble with mental focus, and scalp tenderness. Symptoms are often worse later in the day.
TREATMENT OF TENSION HEADACHES
Treating a tension headache involves relaxation techniques and pain meds in the NSAID family like ibuprofen (Advil). Some feel relief simply by taking acetaminophen (Tylenol). Excessive use of medications, however, may lead to “rebound” headaches, where the headache pain returns when off the drug.
A number of prescription medications like naproxen or even stronger drugs are also used in severe cases. If muscle spasm is suspected, prescription medications like cyclobenzaprine (Flexeril) may be of use. Cold packs to the affected area may help.
Holistic relaxation techniques include massage, regular exercise, yoga, meditation, and deep breathing. Here are some additional options.
Biofeedback training is another way to reduce stress that can cause a tension headache. This method uses devices that monitor heart rate, blood pressure, and muscle tension. It attempts to give you “feedback” to help control some of the factors that lead to headache. Counseling, also called cognitive therapy, may help by allowing you to voice your stress and explore ways to deal with it.
Some attest to the effectiveness of acupuncture as a therapy. Other use herbal teas: Herbs that have sedative and antispasmodic properties may help relieve the pain of tension headaches. Consider teas made from Valerian, skullcap, lemon balm, or passion flower. Herbal muscle relaxants may also help: Rosemary, chamomile, and mint teas are popular options.
For external use, some alternative healers recommend lavender or rosemary oil. Massage each temple with 1-2 drops as needed.
I’ll bet you have your own home remedy for tension headaches. If so, let me know what works for you. The next part of this series will address cluster, hypertensive, and other headache types.
Joe Alton MD
