How to treat tension headaches: The most common type of headache that affects 66% of US adults

• A tension headache typically feels like a tight band of pain wrapped around the head.
• Tension headaches typically last for a half to several hours, but some can last much longer.
• It's unclear what causes tension headaches but risk factors include stress and eye strain.

Tension headaches are the most common type of headache, estimated to affect about 66% of US adults at some point in their lives.

They cause mild to moderate pain across the forehead or wrapping around the sides and back of the head like a tight band.

Note: The ache from tension headaches is different from the throbbing, pounding pain of a migraine. Moreover, physical activity - like walking up a flight of stairs - doesn't increase the pain or intensity of tension headaches the way it will for migraines.

While most tension headaches will resolve after 30 minutes to several hours, some can last much longer.

Here we offer information to help you determine if your pain is a tension headache and, if yes, how to go about treating it.

How to tell if you have a tension headache

Tension headaches are divided into two main categories:

• Episodic, which lasts anywhere from 30 minutes to a week and occurs fewer than 15 days in a month.
• Chronic, which occurs 15 or more days in a month for at least three consecutive months.

"Most of the time, chronic headache problems evolve from episodic ones. People start out with occasional headaches, but over time they become a bigger and bigger problem," says Christopher H. Gottschalk, MD, FAHS, director of headache medicine and chief of general neurology at Yale Medicine.

Regardless of which type of tension headache you experience, they have several symptoms, including:

• Tightness or pressure across the forehead or on the sides and back of the head
• Mild to moderate pain around the scalp, face, or neck and shoulder muscles

Note: If you also experience migraine symptoms like nausea, vomiting, and fatigue in addition to pain from tension headaches, you may have what's sometimes referred to as a mixed headache.

However, some researchers believe that the different types of headaches -mainly tension vs. migraine - are not separate afflictions, but rather, a continuum of one health condition.

For instance, the ache from a tension headache becomes similar to the throbbing pain of a migraine as it worsens, and when a migraine occurs more often, the closer it resembles a chronic tension headache.

So, symptoms aren't so clear-cut between the two, and that's why some researchers dismiss the different headache classifications.

Causes of tension headaches

The reason for tension headaches is poorly understood. However, there are risk factors that can make you more susceptible to them, such as:

• Vitamin deficiency, particularly B-12 and D
• Eye strain, like from staring at a computer screen for a long time
• Head and neck pain from other health conditions like a jaw muscle disorder (aka temporomandibular joint syndrome)
• Assigned gender, because women are slightly more prone to tension headaches than men
• Lack of sleep
• Skipping meals
• Stress

Identifying and avoiding these risk factors makes it less likely for headaches to develop or get worse later on, says Gottschalk.

How to treat tension headaches

There are several ways to treat a tension headache, which include:

• Pain relievers: In general, headaches are usually treated with over-the-counter pain relievers like aspirin, ibuprofen (Advil or Motrin), naproxen sodium (Aleve), or acetaminophen (Tylenol). Combination medications with two or more active ingredients (Excedrin), and prescription pain medications that treat stronger pain or chronic headaches, such as naproxen (Naprosyn) or indomethacin (Indocin), may also help. Refrain from using pain relievers more than twice a week because the overuse of pain medicines may end up causing what's called medicine overuse headaches.
• Nausea drugs: Researchers have found that headaches may actually delay your ability to absorb pain reliever medication, but a nausea drug may help with that. "Adding a nausea drug like Reglan or Compazine to [OTC pain medications] - even when there isn't any nausea - can significantly improve the response," says Gottschalk.
• Home remedies: Putting a cold compress on your forehead or over the neck and shoulders may relieve your symptoms. Dehydration and poor sleep also trigger headaches, so make sure to drink enough water and sleep well.
• Antidepressants: If pain relievers don't minimize your symptoms, or if you have a chronic tension headache, you may be prescribed tricyclic antidepressants like amitriptyline (Elavil). Venlafaxine (Effexor XR) or mirtazapine (Remeron) are also effective. Antidepressants can reduce the duration and frequency of headaches because it increases the level of serotonin in the brain, which contributes to its pain-relieving properties.

You need to see a doctor if your symptoms interfere with your ability to function, says Gottschalk. Chronic headaches may require further treatment and preventive techniques such as cognitive behavioral therapy, biofeedback (using sensors to learn how to control key body functions), and healthy lifestyle habits like getting enough sleep and exercising regularly.

Important: Keep in mind that an abrupt, severe headache that is accompanied by fever, stiff neck, or confusion - especially after a head injury - requires immediate emergency care as it may indicate a concussion or a more serious underlying health condition like a brain bleed or hemorrhage or meningitis (inflammation of the brain and spinal cord tissue).

Insider's takeaway

Tension headaches involve mild to moderate pain across the forehead or on the sides and back of the head that may last anywhere from 30 minutes to several months.

Several factors like vitamin deficiency, eye strain, and lack of sleep can make you more at risk of developing a tension headache.

If tension headaches interfere with your daily life, you can try relieving the pain with OTC pain relievers or schedule a visit with your primary care physician for prescription medications.

Using treatments that don't really work, like combining Tylenol and soda like Coca-Cola or Pepsi, may worsen headache symptoms over time, says Gottschalk.

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