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Tension Headache

The most common type of headache, characterized by a dull, aching sensation around the head, often described as feeling like a tight band or vice around the skull.

Overview

Tension headaches, also known as tension-type headaches (TTH), are the most prevalent form of primary headache disorder, affecting up to 78% of the general population at some point in their lives. Despite being so common, they are often underdiagnosed and undertreated, with many sufferers dismissing them as "just stress" or a normal part of life. These headaches are characterized by a bilateral, pressing or tightening quality of pain that typically doesn't worsen with routine physical activity.

The term "tension" in tension headache can be misleading, as it doesn't necessarily refer to psychological tension or stress, though these can be triggers. Instead, it originally referred to muscle tension in the head and neck region, though modern understanding suggests the pathophysiology is more complex, involving both peripheral and central pain mechanisms. Tension headaches can significantly impact quality of life, work productivity, and social functioning, particularly when they become chronic.

Tension headaches are classified into three subtypes based on frequency: infrequent episodic (less than once per month), frequent episodic (1-14 days per month), and chronic (15 or more days per month for at least 3 months). This classification is important because it guides treatment approaches and helps predict prognosis. While episodic tension headaches are usually manageable with simple interventions, chronic tension headaches often require comprehensive management strategies and may be associated with other conditions such as depression or anxiety disorders.

Symptoms

Tension headaches present with a distinct pattern of symptoms that differentiate them from other headache types. The pain is typically described as dull, aching, and non-pulsating, creating a sensation of pressure or tightness around the entire head. Unlike migraines, tension headaches usually don't cause severe disability, allowing most people to continue their daily activities despite the discomfort.

Red Flag Symptoms

Seek immediate medical attention if your headache is sudden and severe ("thunderclap"), accompanied by fever and stiff neck, follows a head injury, worsens despite treatment, or is associated with confusion, vision changes, difficulty speaking, or weakness.

Primary Symptoms

Headache
Neck Stiffness or Tightness
Neck Pain
Anxiety and Nervousness

Associated Symptoms

Dizziness
Nausea
Back Cramps or Spasms
Chills

Characteristic Features

The pain of tension headaches has several distinguishing characteristics:

  • Bilateral location: Affects both sides of the head simultaneously
  • Quality: Pressing or tightening sensation, not pulsating
  • Intensity: Mild to moderate, rarely severe
  • Duration: 30 minutes to 7 days for episodic types
  • Pattern: Often worse later in the day
  • Distribution: "Hatband" pattern around the head, may include forehead, temples, or back of head

What Tension Headaches DON'T Usually Cause

Understanding what symptoms are NOT typical helps distinguish tension headaches from other conditions:

  • No significant nausea or vomiting (mild nausea occasionally)
  • No sensitivity to both light AND sound (may have one or the other)
  • No aura or visual disturbances
  • No worsening with routine physical activity
  • No throbbing or pulsating quality
  • No unilateral (one-sided) location

Associated Physical Findings

Physical examination may reveal:

  • Muscle tenderness: Pericranial muscles, neck, and shoulders
  • Trigger points: Specific tender spots in muscles
  • Limited neck range of motion: Due to muscle tightness
  • Poor posture: Forward head position, rounded shoulders
  • Jaw clenching: Signs of temporomandibular dysfunction

Symptom Patterns

Type Frequency Duration Impact
Infrequent Episodic <1 day/month 30 min - 7 days Minimal
Frequent Episodic 1-14 days/month 30 min - 7 days Moderate
Chronic ≥15 days/month Hours to continuous Significant

Causes

The exact cause of tension headaches remains incompletely understood, but research suggests a multifactorial origin involving both peripheral and central mechanisms. Unlike the historical belief that these headaches were purely due to muscle tension, current evidence points to a complex interplay of muscular, neurological, and psychological factors. Understanding these mechanisms helps explain why treatment approaches need to be comprehensive and individualized.

Peripheral Mechanisms

Muscle Tension and Trigger Points

  • Sustained muscle contraction: Prolonged tension in head, neck, and shoulder muscles
  • Myofascial trigger points: Hyperirritabile spots in muscle tissue
  • Poor posture: Forward head position increases muscle strain
  • Jaw clenching: Temporomandibular joint dysfunction contributes
  • Eye strain: Prolonged computer use or uncorrected vision

Peripheral Sensitization

  • Increased sensitivity of nociceptors in muscles
  • Release of inflammatory mediators
  • Reduced pain threshold in affected muscles
  • Referred pain patterns from neck to head

Central Mechanisms

Central Sensitization

In chronic tension headaches, central pain processing becomes altered:

  • Hyperexcitability: Increased response to normal stimuli
  • Wind-up phenomenon: Progressive increase in pain response
  • Impaired descending inhibition: Reduced natural pain suppression
  • Altered brain connectivity: Changes in pain processing networks

Neurotransmitter Imbalances

  • Serotonin: Low levels associated with chronic pain
  • Norepinephrine: Affects pain modulation
  • Endorphins: Natural pain relievers may be insufficient
  • Substance P: Increased levels in chronic sufferers

Triggers and Precipitating Factors

Physical Triggers

  • Poor posture: Desk work, smartphone use
  • Sleep problems: Too little or too much sleep
  • Dehydration: Inadequate fluid intake
  • Hunger: Skipped meals, low blood sugar
  • Physical exertion: Overexertion without proper conditioning
  • Weather changes: Barometric pressure fluctuations

Psychological Triggers

  • Stress: Work, family, or financial pressures
  • Anxiety: Worry and tension
  • Depression: Often coexists with chronic headaches
  • Emotional conflicts: Suppressed anger or frustration
  • Perfectionism: High self-expectations

Environmental Factors

  • Bright or flickering lights: Fluorescent lighting
  • Loud noises: Constant background noise
  • Strong odors: Perfumes, chemicals
  • Poor ergonomics: Improper workstation setup
  • Temperature extremes: Very hot or cold environments

The Transformation Process

How episodic headaches become chronic:

  1. Initial episodes: Triggered by specific factors
  2. Increased frequency: More triggers or lower threshold
  3. Central sensitization: Brain becomes hypervigilant
  4. Medication overuse: Rebound headaches develop
  5. Chronic daily headache: Continuous or near-continuous pain

Genetic and Constitutional Factors

  • Family history: Genetic predisposition to headaches
  • Gender: Women affected more than men (2:1 ratio)
  • Age: Peak prevalence in 30s and 40s
  • Personality traits: Type A personality, perfectionism
  • Pain sensitivity: Individual variation in pain perception

Risk Factors

Understanding the risk factors for tension headaches helps identify individuals who are more susceptible and guides prevention strategies. While some risk factors are modifiable through lifestyle changes, others are inherent characteristics that require adaptive management approaches. Recognizing these factors early can prevent the progression from episodic to chronic headaches.

Demographic Risk Factors

  • Gender: Women are twice as likely to experience tension headaches
  • Age: Peak prevalence between ages 30-39, but can occur at any age
  • Education level: Higher prevalence in those with higher education
  • Socioeconomic status: More common in middle-income groups
  • Occupation: Office workers, students, healthcare professionals at higher risk

Lifestyle Factors

Sleep Patterns

  • Irregular sleep schedule
  • Sleep deprivation (<6 hours/night)
  • Oversleeping (>9 hours/night)
  • Poor sleep quality
  • Sleep apnea or other sleep disorders

Physical Activity

  • Sedentary lifestyle
  • Lack of regular exercise
  • Poor physical conditioning
  • Excessive physical strain without proper preparation

Dietary Factors

  • Irregular meal patterns
  • Dehydration
  • Excessive caffeine consumption
  • Caffeine withdrawal
  • Low blood sugar from skipped meals

Occupational and Environmental Factors

  • Prolonged computer use: Eye strain and poor posture
  • Poor workstation ergonomics: Improper desk and chair setup
  • High job demands: Deadline pressure, multitasking
  • Low job control: Limited autonomy in work decisions
  • Shift work: Disrupted circadian rhythms
  • Poor lighting: Glare, flickering lights
  • Noise exposure: Constant background noise

Psychological Risk Factors

  • Chronic stress: Work, family, or financial pressures
  • Anxiety disorders: Generalized anxiety, panic disorder
  • Depression: Major depressive disorder increases risk 3-fold
  • Type A personality: Competitive, time-urgent behavior
  • Perfectionism: Unrealistic self-expectations
  • Poor stress coping mechanisms: Lack of effective stress management
  • History of trauma: Physical or emotional trauma

Medical Risk Factors

  • Other headache disorders: Migraine coexistence
  • Temporomandibular disorders: Jaw joint dysfunction
  • Neck problems: Cervical spine disorders
  • Vision problems: Uncorrected refractive errors
  • Chronic pain conditions: Fibromyalgia
  • Sleep disorders: Insomnia, sleep apnea
  • Hormonal factors: Menstruation, menopause

Medication-Related Factors

  • Medication overuse: Regular use of pain relievers (>2-3 days/week)
  • Caffeine in medications: Can lead to withdrawal headaches
  • Certain medications: Some blood pressure medications, hormones
  • Substance withdrawal: Alcohol, caffeine, nicotine

Risk Factors for Chronification

Factors that increase the risk of episodic headaches becoming chronic:

  • High frequency of episodic headaches (>10 days/month)
  • Medication overuse
  • Obesity
  • Stressful life events
  • Poor sleep quality
  • Comorbid depression or anxiety
  • Low socioeconomic status
  • History of head or neck trauma

Risk Assessment

Having multiple risk factors doesn't guarantee you'll develop tension headaches, but it does increase your likelihood. Focus on modifying controllable factors like stress management, sleep hygiene, and posture to reduce your risk.

Diagnosis

Diagnosing tension headaches primarily relies on clinical history and physical examination, as there are no specific tests or biomarkers for this condition. The diagnosis is made by ensuring the headache characteristics match tension-type headache criteria while excluding other potential causes. A thorough evaluation is essential to differentiate tension headaches from other primary headache disorders and to rule out secondary causes.

Diagnostic Criteria (ICHD-3)

The International Classification of Headache Disorders (ICHD-3) criteria for tension-type headache:

A. At least 10 episodes fulfilling criteria B-D

B. Headache lasting 30 minutes to 7 days

C. At least two of the following:

  • Bilateral location
  • Pressing or tightening quality (non-pulsating)
  • Mild or moderate intensity
  • Not aggravated by routine physical activity

D. Both of the following:

  • No more than one of: photophobia, phonophobia, or mild nausea
  • Neither moderate/severe nausea nor vomiting

E. Not better accounted for by another diagnosis

Clinical History

Key Questions to Ask

  • Location: Where exactly is the pain located?
  • Quality: How would you describe the pain?
  • Timing: When did headaches start? How often do they occur?
  • Duration: How long does each headache last?
  • Triggers: What seems to bring on the headaches?
  • Relief: What makes them better or worse?
  • Associated symptoms: Any nausea, visual changes, or other symptoms?
  • Impact: How do headaches affect daily activities?

Headache Diary

Patients should track:

  • Date and time of headache onset
  • Duration and intensity (1-10 scale)
  • Possible triggers
  • Medications taken and response
  • Associated symptoms
  • Impact on activities

Physical Examination

General Examination

  • Vital signs (blood pressure, temperature)
  • General appearance and affect
  • Signs of systemic illness

Neurological Examination

  • Cranial nerve assessment
  • Motor strength and reflexes
  • Sensory testing
  • Coordination and gait
  • Fundoscopic exam (check for papilledema)

Musculoskeletal Examination

  • Palpation: Tender points in head, neck, and shoulder muscles
  • Range of motion: Cervical spine mobility
  • Posture assessment: Forward head position, shoulder alignment
  • TMJ evaluation: Jaw movement, clicking, tenderness
  • Trigger points: Specific areas of muscle tenderness

Red Flags Requiring Further Investigation

  • New headache pattern after age 50
  • Sudden onset severe headache
  • Progressive worsening pattern
  • Headache with fever and stiff neck
  • Headache with neurological signs
  • Headache after head trauma
  • Headache worse with coughing/straining
  • Headache with vision changes
  • History of cancer or HIV

Diagnostic Testing

Usually not necessary for typical tension headaches, but may include:

When to Consider Imaging

  • Abnormal neurological examination
  • Red flag symptoms present
  • Significant change in headache pattern
  • First or worst headache
  • Patient or physician concern

Types of Tests

  • CT scan: Quick assessment for acute issues
  • MRI: Better for chronic headache evaluation
  • Blood tests: If systemic disease suspected
  • ESR/CRP: If temporal arteritis suspected (age >50)
  • Lumbar puncture: If infection or increased pressure suspected

Differential Diagnosis

Conditions to distinguish from tension headaches:

Diagnostic Challenges

Many patients have features of both tension-type and migraine headaches. This "mixed" pattern is common and may require treatment approaches that address both headache types. Keeping a detailed headache diary helps clarify patterns and guide treatment.

Treatment Options

Treatment of tension headaches requires a comprehensive approach tailored to the frequency and severity of symptoms. The goal is not only to relieve acute pain but also to prevent headaches and improve quality of life. Treatment strategies differ significantly between episodic and chronic tension headaches, with chronic forms requiring more intensive, multimodal approaches.

Acute Treatment

Over-the-Counter Medications

  • Acetaminophen: 1000mg, effective for mild to moderate pain
  • Ibuprofen: 400-800mg, anti-inflammatory benefits
  • Aspirin: 500-1000mg, avoid if stomach sensitivity
  • Naproxen: 220-550mg, longer duration of action
  • Combination products: Acetaminophen + caffeine may enhance efficacy

Medication Overuse Warning

Limit acute medications to no more than 2-3 days per week to avoid medication overuse headaches. Using pain relievers more than 10 days per month can lead to rebound headaches and chronic daily headache.

Non-Pharmacological Acute Relief

  • Rest: In a quiet, comfortable environment
  • Cold or heat therapy: Ice pack or warm compress to head/neck
  • Gentle stretching: Neck and shoulder exercises
  • Relaxation techniques: Deep breathing, progressive muscle relaxation
  • Hydration: Drink water if dehydrated
  • Caffeine: Small amount may help (beware of dependence)

Preventive Treatment

For frequent episodic or chronic tension headaches:

Pharmacological Prevention

Antidepressants (First-line)
  • Amitriptyline: 10-75mg at bedtime, most evidence
  • Nortriptyline: 10-75mg, fewer side effects than amitriptyline
  • Venlafaxine: 75-225mg, SNRI with good efficacy
  • Mirtazapine: 15-30mg, helps with sleep
Other Preventive Medications
  • Tizanidine: 2-6mg, muscle relaxant properties
  • Topiramate: 25-100mg, also prevents migraines
  • Gabapentin: 300-1200mg, for neuropathic component
  • Botulinum toxin: Injections for chronic cases

Non-Pharmacological Therapies

Physical Therapies

  • Physical therapy: Posture correction, strengthening exercises
  • Manual therapy: Massage, mobilization, manipulation
  • Dry needling: For myofascial trigger points
  • TENS unit: Transcutaneous electrical nerve stimulation
  • Acupuncture: Evidence supports efficacy

Behavioral Interventions

  • Cognitive behavioral therapy (CBT): Addresses pain thoughts and behaviors
  • Biofeedback: Learn to control muscle tension
  • Stress management: Identify and manage stressors
  • Relaxation training: Progressive muscle relaxation, meditation
  • Sleep hygiene: Regular sleep schedule, proper sleep environment

Lifestyle Modifications

  • Regular exercise: 30 minutes aerobic exercise 3-5 times/week
  • Posture improvement: Ergonomic workstation setup
  • Regular meal schedule: Avoid skipping meals
  • Adequate hydration: 8-10 glasses of water daily
  • Limit caffeine: No more than 200mg daily
  • Stress reduction: Yoga, mindfulness, hobbies

Complementary Therapies

  • Herbal supplements: Feverfew, butterbur (limited evidence)
  • Magnesium: 400-600mg daily may help
  • Riboflavin (B2): 400mg daily
  • Coenzyme Q10: 100mg three times daily
  • Essential oils: Peppermint, lavender for topical use

Treatment Approach by Type

Headache Type Primary Treatment Additional Measures
Infrequent Episodic OTC analgesics as needed Lifestyle modifications
Frequent Episodic Limit analgesics + preventive Stress management, PT
Chronic Daily preventive medication Multimodal approach, CBT

Managing Chronic Tension Headaches

Requires comprehensive approach:

  1. Withdraw overused medications: Gradual taper if necessary
  2. Start preventive medication: Allow 2-3 months for effect
  3. Address comorbidities: Treat depression, anxiety, sleep disorders
  4. Implement behavioral strategies: CBT, biofeedback
  5. Physical rehabilitation: Correct posture, strengthen muscles
  6. Regular follow-up: Monitor progress, adjust treatment

Treatment Success Tips

Successful treatment often requires patience and a multimodal approach. Keep a headache diary to track triggers and treatment response. Don't get discouraged if the first treatment doesn't work—finding the right combination often takes time.

Prevention

Preventing tension headaches is often more effective than treating them after they occur. A comprehensive prevention strategy addresses multiple factors including lifestyle, stress management, physical health, and environmental modifications. The key is identifying and modifying personal triggers while building resilience through healthy habits.

Lifestyle Prevention Strategies

Sleep Hygiene

  • Regular schedule: Same bedtime and wake time daily
  • Adequate duration: 7-9 hours per night
  • Quality environment: Dark, quiet, cool room
  • Avoid screens: No devices 1 hour before bed
  • Comfortable bedding: Supportive pillow and mattress
  • Wind-down routine: Relaxing activities before sleep

Stress Management

  • Time management: Prioritize tasks, avoid overcommitment
  • Regular breaks: 5-10 minute breaks every hour
  • Relaxation techniques: Daily practice of chosen method
  • Social support: Maintain healthy relationships
  • Hobby time: Regular enjoyable activities
  • Professional help: Counseling for chronic stress

Physical Prevention

Exercise Program

  • Aerobic exercise: 30 minutes, 3-5 times weekly
  • Strength training: Focus on neck and upper back
  • Flexibility: Daily stretching routine
  • Yoga or Pilates: Combines strength and flexibility
  • Swimming: Low-impact full-body exercise
  • Walking: Simple, accessible daily activity

Posture and Ergonomics

  • Workstation setup: Monitor at eye level, feet flat on floor
  • Chair support: Lumbar support, armrests at proper height
  • Keyboard position: Elbows at 90 degrees
  • Phone use: Headset or speakerphone, avoid cradling
  • Regular position changes: Stand and move hourly
  • Posture awareness: Shoulders back, chin tucked

Dietary Prevention

  • Regular meals: Three meals plus healthy snacks
  • Stable blood sugar: Avoid long gaps between meals
  • Adequate hydration: 8-10 glasses of water daily
  • Limit caffeine: No more than 200mg daily
  • Avoid triggers: Identify personal food triggers
  • Balanced nutrition: Adequate vitamins and minerals

Environmental Modifications

Home Environment

  • Proper lighting to reduce eye strain
  • Control noise levels
  • Maintain comfortable temperature
  • Good air quality and ventilation
  • Organized, clutter-free spaces

Work Environment

  • Adjustable desk and chair
  • Anti-glare screen filters
  • Proper task lighting
  • Noise-canceling headphones if needed
  • Plants for improved air quality

Trigger Identification and Management

Common Triggers to Monitor

  • Stress and emotional upset
  • Missed meals or dehydration
  • Sleep changes
  • Weather changes
  • Hormonal fluctuations
  • Certain foods or drinks
  • Strong smells or bright lights

Trigger Management Strategy

  1. Keep detailed headache diary
  2. Identify patterns and triggers
  3. Develop avoidance strategies
  4. Create coping plans for unavoidable triggers
  5. Regular review and adjustment

Preventive Routines

Daily Prevention Checklist

  • Morning stretches (5-10 minutes)
  • Healthy breakfast
  • Hydration throughout day
  • Hourly movement breaks
  • Stress check-ins and mini-relaxations
  • Evening wind-down routine

Weekly Prevention Activities

  • Review headache diary
  • Plan healthy meals
  • Schedule exercise sessions
  • Practice stress management techniques
  • Assess and adjust workspace
  • Social and recreational activities

When Prevention Isn't Enough

Signs you need additional help:

  • Increasing headache frequency despite prevention
  • Need for pain medication more than 2 days/week
  • Significant impact on daily activities
  • Development of chronic daily headache
  • Associated mood changes or sleep problems

Prevention Success

Successful prevention requires consistency and patience. It may take 2-3 months to see the full benefits of lifestyle changes. Track your progress with a headache diary to identify which strategies work best for you.

When to See a Doctor

While most tension headaches can be managed with self-care, certain situations require medical evaluation. Knowing when to seek professional help ensures proper diagnosis and treatment while avoiding potentially serious complications. Don't hesitate to consult healthcare providers when headaches affect your quality of life or show concerning features.

Seek Emergency Care Immediately For:

  • "Thunderclap" headache: Sudden, severe headache reaching maximum intensity within seconds
  • Headache with fever and stiff neck: Possible meningitis
  • Headache after head injury: Especially with confusion or vomiting
  • Headache with neurological symptoms: Weakness, numbness, difficulty speaking
  • Headache with vision loss: Sudden blindness or double vision
  • Worst headache of your life: Significantly different from usual headaches
  • Headache with seizures: New onset seizures

Schedule an Urgent Appointment If You Have:

  • New headache pattern after age 50
  • Progressive worsening of headaches over days/weeks
  • Headache pattern that has significantly changed
  • Headaches that wake you from sleep
  • Headache with unexplained weight loss
  • Headache worse with coughing, straining, or bending
  • Persistent headache after COVID-19 infection

Make a Regular Appointment For:

Frequency Concerns

  • Headaches occurring more than 15 days per month
  • Need for pain medication more than 2-3 days per week
  • Headaches interfering with work or daily activities
  • Increasing frequency or severity over time

Treatment Concerns

  • Over-the-counter medications no longer effective
  • Side effects from headache medications
  • Concern about medication overuse
  • Need for preventive medication options

Associated Symptoms

  • Chronic neck pain or stiffness
  • Jaw pain or TMJ symptoms
  • Sleep disturbances
  • Mood changes (depression, anxiety)
  • Memory or concentration problems

What to Bring to Your Appointment

  • Headache diary: At least 1-2 months of records
  • Medication list: All current medications and supplements
  • Previous tests: Any prior imaging or test results
  • Family history: Information about headaches in family
  • Trigger list: Identified triggers and patterns
  • Questions: Written list of concerns

Questions Your Doctor May Ask

  • When did your headaches first begin?
  • How often do you get headaches?
  • What does the pain feel like?
  • Where is the pain located?
  • How long do headaches typically last?
  • What makes them better or worse?
  • Do you have any warning signs?
  • How do headaches affect your daily life?

When to See a Specialist

Referral to a neurologist or headache specialist may be appropriate for:

  • Chronic daily headaches not responding to treatment
  • Complex medication management needs
  • Unclear diagnosis despite evaluation
  • Need for specialized procedures (nerve blocks, Botox)
  • Coexisting neurological conditions

Don't Wait Too Long

Many people suffer unnecessarily with frequent headaches, thinking they're "just stress" or "normal." If headaches regularly interfere with your life, seek help. Effective treatments are available, and early intervention can prevent progression to chronic daily headache.

Frequently Asked Questions

Are tension headaches the same as stress headaches?

Yes, tension headaches are often called stress headaches because stress is a common trigger. However, the name "tension headache" originally referred to muscle tension, not emotional tension. Many factors besides stress can trigger these headaches, including poor posture, eye strain, and dehydration.

Can children get tension headaches?

Yes, children can experience tension headaches, though they're more common in adolescents and adults. In children, symptoms may be harder to describe, and behavioral changes like irritability may be more noticeable than verbal complaints of pain. School stress, poor posture from heavy backpacks, and excessive screen time are common triggers.

Is it normal to have tension headaches every day?

No, daily headaches are not normal and indicate chronic tension-type headache, which affects about 3% of adults. This requires medical evaluation to rule out other causes and develop an appropriate treatment plan. Medication overuse is a common cause of daily headaches.

Can tension headaches turn into migraines?

Tension headaches don't transform into migraines, but many people experience both types. Some headaches have mixed features, making classification difficult. It's also possible for a tension headache to trigger a migraine in susceptible individuals, or for chronic neck tension to lower the threshold for migraines.

Why do I wake up with tension headaches?

Morning tension headaches often result from overnight teeth grinding (bruxism), poor sleep posture, or using unsuitable pillows. Sleep apnea, dehydration, and caffeine withdrawal can also cause morning headaches. Addressing these factors often resolves the problem.

Can weather changes cause tension headaches?

Yes, some people are sensitive to weather changes, particularly barometric pressure drops before storms. While more common with migraines, weather can trigger tension headaches in susceptible individuals. Staying hydrated and maintaining regular routines during weather changes may help.

Are tension headaches hereditary?

There's a genetic component to headache susceptibility, though it's less pronounced than with migraines. If your parents had frequent headaches, you're more likely to experience them. However, environmental factors and learned behaviors (like stress responses) also play significant roles.

Can exercise help or worsen tension headaches?

Regular moderate exercise typically helps prevent tension headaches by reducing stress, improving posture, and increasing endorphins. However, sudden intense exercise without proper warm-up, dehydration during exercise, or exercises that strain the neck can trigger headaches. The key is consistent, appropriate exercise.

How long should I try a preventive medication before deciding it doesn't work?

Most preventive medications require 2-3 months at an adequate dose to show full benefit. Don't stop too soon—many people give up after a few weeks. Keep a headache diary to objectively track improvement, as gradual changes may not be immediately noticeable.

Medical Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References

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