What are Tension Headaches and how they are treated

Regular readers of our blogs and who follow us on Facebook may have worked out that the theme for the latter half of this month is headaches.

Following on from last weeks more general overview of the different types of headaches, this weeks article will focus on the common muscular tension-type headache.

Headaches are very common, the 'scourge of modern society' so they have been described. My perception is that many suffer in silence, perhaps reluctant to admit to suffering from headaches as a sign of vulnerability, or feeling they are something which should just be put up with.

I feel we should be talking more openly about headaches given the negative impact on the quality of life they can have. We all need help at some stage or another, and knowing to ask for help should be considered a sign of strength and not weakness.

CaptureStress and other mood disorders can play a role in headaches, but not always. Very often the structure and function of the neck may have become impaired, creating a referral of pain to the head. Myofascial trigger points within the neck muscles are a common cause of pain referral the image (courtesy of the BMAS) accompanying this article shows. If stress is an issue, there are strategies which can be put in place. If the neck is part of the problem, physiotherapy treatment can help. Sometimes its a mix of both what would be referred to as psychosocial and musculoskeletal issues. The key is to be properly assessed so that the root cause of the headaches can be addressed.

Other factors may include
- Caffeine (too much or withdrawal)
- Colds, the flu or a sinus infection
- Dental problems such as jaw clenching or teeth grinding
- Eyestrain
- Excessive smoking
- Fatigue or overexertion

What does a tension headache feel like?

- Felt on both sides of the head, often starting in the neck area
- Feels like a pressing, tightening (non-throbbing/pulsing)
- Mild to moderate intensity
- Can last up to 30 mins or be continuous

How is tension headache treated?

- Managing precipitating factors, lifestyle management
- Medical Acupuncture including gentle dry needling for which there is very good research to support its efficacy and effectiveness.1,2
- Therapeutic exercise
- Certain medications e.g Amitriptyline (can combine with acupuncture for improved overall effect)
- Stress management strategies.

Please don’t suffer from his type of headache when it can be effectively treated. Taking regular over the counter painkillers may help in the short term, however, they become less effective over time and may actually start to cause headaches...the so-called rebound headaches which occur due to analgesic overuse.

As an intermittent tension headache sufferer myself, I can attest to the amazing relief I feel during and after a physiotherapy treatment session involving medical acupuncture and manual therapy. Tender trigger points within my neck muscles are usually the target for gentle needling. I make sure to get treatment as soon as I start to feel the symptoms beginning, this way I usually only require a few sessions which settles the headaches for a number of months...as long as I do my exercises!


1. Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, Vickers A, White AR. Acupuncture for the prevention of tension‐type headache. Cochrane Database of Systematic Reviews. 2016(4).




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A Physio's guide to Headaches

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