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Headaches Due To Tension

more about Headaches Due To Tension


There are two types of Headaches due to tension:

1. Simple Tension (or Muscle-Contraction) Headaches. Ninety percent of all Headaches are classified as tension/muscle contraction Headaches, which are triggered by stress.

2. Chronic Tension Headaches. This type of tension headache is less severe than cluster or Migraine Headaches and occurs equally in both sexes. It may last weeks, months or even years.


Simple Tension Headaches are often accompanied by the contraction of neck, face, and scalp muscles brought on by stressful events. They are severe, but a temporary form of muscle-contraction Headaches. The pain(N) is mild to moderate, and feels like pressure(N) is being applied to the head or neck.

With Chronic Tension Headaches, pain(N) is felt on both sides of the head (a "hatband" effect), and neck pain is constant. No other associated symptoms, like Nausea or auras, are present. Chronic Tension Headaches are not necessarily precipitated by emotional stress; in fact, similar to migraines(N), they may be due to neurochemical changes in the brain.


Emotional factors and certain physical postures that tense head and neck muscles (such as prolonged writing, holding a phone between the shoulder and ear, and even gum-chewing) may increase the chance of muscle contraction Headaches. Other disorders(N), such as degenerative Arthritis of the Neck and temporomandibular joint dysfunction, which result from a poor bite and jaw clenching, can aggravate the head and neck muscles and lead to muscle/contraction tension type of Headaches.

A Headache occurs when nociceptors, or pain(N) sensing nerve endings, are triggered by stress, muscular tension, or the dilation of blood vessels. The areas of the head that contain nociceptors are the scalp, face, mouth, throat, muscles of the head, and blood vessels at the base of the brain. The bones of the skull and tissues of the brain do not contain nociceptors.

Nociceptors transmit a message to the deep structures of the brain, which receives the signal and detects where the pain(N) has originated. Involved in this pathway of signal transmission are many chemicals known as neurotransmitters, which include epinephrine, serotonin histamine, dopamine, acetylcholine, norepinephrine, Gamma-aminobutyric acid (GABA), Glutamate, beta-endorphin, enkephalin, substance P, bradykinin, neuropeptide Y and others. Many scientists believe that most Headaches occur due to the alteration in levels and functioning of these chemicals.

More recent theories suggest that some complex Headaches, like migraines(N), may occur when blood vessels overreact to various triggers, such as a certain foods or beverages, bright lights, odors, Anxiety, or weather changes. This causes spasms that close and severely constrict several arteries supplying oxygen-rich blood to the brain and the areas nearby. As the arteries narrow, blood clotting(N) elements, such as platelets, clump together - a process that is believed to release serotonin (a brain neurotransmitter).

Serotonin acts as a powerful constrictor of arteries, further reducing the blood supply to the brain. In response to this reduction of oxygen-rich blood, other arteries within the brain dilate (open wider) to meet the brain's required oxygen and energy levels. The dilation of arteries leads to the release of pain(N)-producing substances called prostaglandins and other chemicals that cause inflammation and swelling, and increase sensitivity to pain(N) by stimulating the nociceptors. This vicious cycle of events results in Headache and other symptoms associated with migraine.

Although this may not be the cause of tension and other types of Headaches, this theory offers clues on how complex Headaches work and provides direction for future research and treatments.



Most Headaches are diagnosed and treated without diagnostic tests or a specialist.

The assessment of a Headache sufferer should start with the physician taking a complete history of the patient's condition. It should include when the Headache occurs, where they occur, how often, what aggravates and what retriggers them. Identifying the trigger factors may be helpful in treating and preventing further attacks.

Examples of some triggers are:

  • Emotional: family problems, work related problems, career changes, anticipation, Anxiety.
  • Stress: strenuous physical exercise(N) or work, illness, too much or too little sleep.
  • Environmental: bright lights, perfume, tobacco, loud noises, changes in altitude, weather, barometric pressure(N) changes.
  • Chemical: hormonal changes, low blood sugar.
  • Medication use
  • Food and beverages: hard cheese(N), hot dogs, chocolate, nuts, food additives such as monosodium glutamate, wheat, sugar, or milk coffee, alcohol(N) and other products.
  • Digestion problems


The evaluation then continues with a very thorough neurological exam and a detailed examination of the head and neck including scalp, blood vessels, eyes, ears, sinuses, temporomandibular joint, teeth, and the bones and muscles of the neck, shoulders and upper back.

If a diagnosis is uncertain, a number of tests can be useful, such as:

  • Blood tests - may include a complete blood count; a reading for levels of Electrolytes, sodium, chloride, bicarbonate, Potassium including Calcium Magnesium, and liver enzymes; an analysis of kidney(N) functions (BUN, Creatinine levels); and the rate of erythrocyte sedimentation.
  • Imaging tests - cervical or spine X-Rays, sinus X-Rays, head CT scan, and head and neck MRI may be performed if necessary.
  • Lumbar puncture and Electroencephalography, only if necessary.


Treatment may include medications such as non-steroidal anti-inflammatories (NSAIDs), Tylenol, Codeine containing analgesic, muscle relaxants and even antidepressants.
Non-medical treatment such as Biofeedback, relaxation training, acupuncture, herbs, guided imagery, dietary changes, exercise(N) and other lifestyle changes should also be considered.


  • Headaches - general
  • Migraine Headaches
  • Cluster Headaches
  • Ophthalmoplegic Migraine
  • Stroke
  • Subarachnoid Hemorrhage
  • Brain Tumor
  • Headaches due to Brain Tumor
  • Brain Aneurysm
  • Headaches due to brain hemorrhage or aneurysm
  • Headaches due to substance Abuse(P)
  • Headaches due to post-traumatic injuries or Concussion(P)
  • sinus infection or Sinusitis
  • Headaches due to sinus infections
  • Headaches due to changes in intracranial pressure(N)
  • Meningitis
  • Shingles
  • Temporal Arteritis



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