Tension Headache

(Muscle Contraction Headache; Tension-Type Headache)


Tension headache is a spreading, steady head pain that can be mild or severe.

Tension Headache: Areas of Pain

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Tension headaches develop when muscles in the neck, face, and scalp contract.

The cause is not known. Genes are thought to play a role.

Risk Factors

This problem often starts in people who are 25 years of age and older. It is also more common in women.

Other things that may raise the risk are:

  • Stress
  • Mental tension
  • Being emotionally upset


Some tension headaches happen often. Others happen only once in a while. They do not often get in the way of daily activities. Tension headaches are:

  • Felt on both sides of the head
  • Have a pressing or tightening feeling


The doctor will ask about symptoms and past health. A physical exam will be done. This is often enough to make the diagnosis.


The goal is to manage symptoms and lower the risk of future headaches. Choices are:


Over-the-counter pain medicine, such as ibuprofen, is often enough to ease headaches.

A caffeine supplement with a pain reliever may also help. Antidepressants may be given for those with severe headaches. It can lower the risk of future headaches.

Other Management

Easing muscle tension can prevent future headaches. It can also ease headaches that have already started. Steps that may help include:

  • Find and stop causes of tension such as poor posture or movement that causes strain in neck and shoulders
  • Regular exercise to strengthen area and ease tension
  • Massage
  • Hot or cold packs—whichever works best
  • Physical therapy to address regular tension or pain problems in neck
  • Stress management and relaxation methods
  • Biofeedback to learn how to control muscle tension


Managing stress and regular healthy movement may prevent headaches.


National Headache Foundation


Canadian Headache Society


Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211.
Headache information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. Updated December 31, 2019. Accessed April 9, 2020.
Tension-type headache. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/tension-type-headache . Updated February 8, 2017. Accessed April 9, 2020.
Tension-type headache. National Headache Foundation website. Available at: https://headaches.org/2007/10/25/tension-type-headache. Accessed April 9, 2020.
Last reviewed February 2021 by EBSCO Medical Review Board Rimas Lukas, MD
Last Updated: 4/9/2021

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