How to Relieve a Tension Headache: Symptoms and Treatment

Tension headaches are the most common form of headache, making someone feel like there is a steel band tightening around their head. Even though they’re not considered debilitating, tension headaches can affect your productivity at work, activities at home and your overall quality of life. Unlike migraines and other types of headaches, tension headaches are usually self-managed and are only brought to a doctor’s attention when they become chronic.

“What makes tension headaches different from other common headache disorders is that they are not seriously debilitating, rarely come with other symptoms besides the headache and often resolve on their own,” according to Dr. Jessica Ailani, director of the Medstar Headache Center at Medstar Georgetown University Hospital in Washington, D.C.

[Read: Best TMJ Exercises for Jaw Pain Relief.]

What Are Tension Headaches?

Tension headaches are divided into three categories but share similar symptoms. The three types of tension headaches include:

Infrequent episodic tension headaches. These tension headaches happen no more than once a month.

Frequent episodic tension headaches. These present as more than one, but fewer than 15 headaches a month for three or more months.

Chronic tension headaches. These affect around 4% of the general population with up to 65% of cases being women, according to a systematic overview published in BMJ Clinical Evidence. These headaches occur 15 or more days a month and can last hours to over a week.

According to Dr. Mark Green, emeritus director of headache and pain medicine at the Icahn School of Medicine at Mount Sinai Hospital in New York City, “Like most types of headaches there is no definitive diagnostic test to confirm if a patient has a tension headache. Currently, for many doctors making a clinical diagnosis, it is more of an art than a science.”

[READ: Vitamins for Stress: Do They Work?]

Tension Headache Symptoms

The most common symptoms of tension headaches to watch for include:

— Bilateral pain, meaning the pain is felt on both sides of the head.

— Mild to moderate intensity pain.

— Physical activity doesn’t worsen symptoms.

— A pressing or tightening in quality around the head.

— No more than one of the following: sensitivity to light or sensitivity to sound.

Tension headaches can be caused by a variety of triggers such as eye strain, lack of sleep, dehydration, day-to-day stress, not eating and tight muscles in the back of the head or neck. Unlike many migraines, tension headaches are not considered to be hereditary, according to the Cleveland Clinic.

“The most striking correlation observed is that tension headaches are frequently brought on by what can be termed the ‘hassles of daily life,'” Green explains. Studies have shown that people who suffer from chronic headaches report significantly more daily hassles than those who do not experience headaches.

[See: Best Foods to Eat — and Avoid — for Migraines.]

Tension Headaches vs. Migraines

Even though tension headaches are the most common form of headache, migraines typically seize more attention from mainstream media and the scientific community. Migraines are severe and cause debilitating, and throbbing pain.

In contrast, tension headaches cause mild to moderate tightness or pressure pain, which is distracting but not debilitating. Tension headaches present on both sides of the head while migraines form on one side of the head. Tension headaches are not typically associated with visual or sound sensitivity, whereas either or both are a primary symptom of migraines.

Physical activity doesn’t increase the intensity of tension headaches whereas it may worsen migraine symptoms. In fact, a 2021 study showed that light exercise may help reduce the frequency of tension headaches.

How to Relieve Tension Headaches

Most tension headaches can be managed by over-the-counter medications, including:

— Acetaminophen, including Tylenol.

— Acetaminophen, aspirin and caffeine, including Excedrin.

— Acetaminophen and caffeine, including Excedrin Tension Headache.

— Aspirin, including Ecotrin.

— Naproxen sodium, including Aleve.

— Ibuprofen, including Advil and Motrin.

Some sufferers find tension headache relief with combination medications, which combine their main ingredient with either caffeine or another ingredient.

These over-the-counter medicines are usually recommended as the first line of defense, but if you keep getting these headaches make sure to identify what might be triggering the episodes. Awareness of what is contributing to your headaches and making some adjustments accordingly can help you avoid many of them in the future.

It’s important not to overuse pain relief medications as they can lead to medication overuse headaches, also called rebound headaches. If you are regularly taking pain relief medications more than a few times a week, talk with your doctor to see if another form of pain relief may be better for you.

Preventing Tension Headaches

If you experience debilitating tension headaches on a frequent basis, your doctor may prescribe a preventive medication.

The most commonly used medications for tension headaches are tricyclic antidepressants, including amitriptyline and protriptyline. The side effects of these medications may include constipation, drowsiness and dry mouth. Other antidepressants are also considered, which may include Effexor, Prozac or Paxil. Common side effects are fatigue, weight gain and nausea.

If you experience a lot of tightness in your head, neck or shoulder muscles your doctor may consider a muscle relaxant. Fatigue, dry mouth and dizziness are the common side effects of these drugs.

“Since the pressures of daily life can also lead to tension headaches, it’s important to slow down and find ways to reduce stress,” Ailani says. Simple ways to better manage stress include massages, yoga and meditation that can help bring focus and emotional calm to busy lives.

When to See Your Doctor for Tension Headaches

It’s time to see a doctor when:

— Your headaches are disabling, causing you to miss out on daily activities.

— Headaches are not responding to over-the-counter pain relief medications.

— You’re regularly taking over-the-counter medications several times a week.

“If headaches start after the age of 50, come with any neurological symptoms such as loss of vision or change in speech, if you have associated nausea or light sensitivity or sound sensitivity with your headache, these are also common reasons to seek medical care,” Ailani says.

“When people are also diagnosed with other medical conditions such as uncontrolled blood pressure, diabetes or a history of cancer, these are reasons to mention headaches to your doctor even if they are controlled with over-the-counter medications.”

More from U.S. News

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How to Relieve a Tension Headache: Symptoms and Treatment originally appeared on

Update 07/22/22: This story was previously published at an earlier date and has been updated with new information.

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