Tension Headaches

Believe it or not, but as I sit here in front of the computer to type this, I have to keep squeezing my left eye shut due to sharp intense pain on the left side of my head!

I have suffered from headaches since I was a teenager and migraines all my adult life, so I know, first hand, just how debilitating headaches can be.

Tension headaches are the most common headache. Researchers don’t know what exactly causes tension headaches but suggests that infrequent tension headaches may be caused by activating nerve cells that send sensory information from pain receptors to the brain. It happens intermittently in up to 80% of the population. As the symptoms are not as severe as a migraine, tension headaches are only considered a problem if it becomes frequent or long-term. It is believed that muscle tension, the central nervous system (nerves and chemicals in the brain), and changes in the blood vessels, may all play a role.


Frequent tension headaches are recognised when you experience at least 10 headaches
in a one month period. There are varying degrees of frequency and chronicity. Chronic tension headache sufferers report headaches on more than 180 days in a year.

The symptoms include:

  • pain on both sides of the head across the temples over the eyes and forehead and wrapping around the head
  • pressing or tightening in nature
  • mild to moderate intensity (and will not tend to interrupt or inhibit your ability to work or continue daily activities).
  • Tension headache sufferers can experience symptoms associated with migraine such as nausea and a hypersensitivity to light and noise, but usually only one of these symptoms.

Although tension headaches, as the name suggests, are frequently triggered or aggravated by stress, they can also stem from:

  • Poor posture – including desk, computer work, work space environment, and sleeping position
  • Long periods looking at screens
  • Eye stress, related to poor vison not being corrected with lenses or eye stress from blue light rays from screens
  • Fatigue
  • Drop in blood sugar, not eating at regular intervals.
  • Stress
  • Poor diet
  • Lack of sleep
  • Hormonal changes
  • Weather changes
  • Alcohol
  • Caffeine


There is no one specific test that identifies tension-type headache. Your diagnosis will
be made based on your symptoms and how you respond to different treatments. If you keep a headache diary this will help your healthcare practitioner determine any patterns or identify any triggers which can help in diagnosing the type of headache you have and advise you on how to prevent them.


Massage to the neck, can be very quick and effective at relieving your tension headache through relaxation of muscles which are under excessive tension or in spasm. It is important to remember that excessive muscle tension can compress, or irritate joint structures, including nerves, that can cause cervicogenic headaches (we will look at this in another post) which will further complicate your symptoms.

Your tension headache treatment may include all or some of the following techniques:

  • Stiff neck joints may need to be loosened or unlocked via joint mobilisation (gentle gliding techniques), joint traction or in specific cases a gentle and localised joint manipulation technique.
  • Hypermobile (or dynamically unstable) joints may require specific deep neck muscle strengthening exercises to stabilise, control and limit the joint movement available.
  • Tight or overactive muscles may require stretching, massage, acupuncture, dry needling, or other relaxation techniques.
  • Weak muscles may require specific strengthening exercises. This may include your postural shoulder blade and neck muscles.
  • Nerve dysfunction may be addressed by your Advanced Remedial Massage Therapist depending upon your specific examination findings. Nerve sensitivity is a common finding associated with neck conditions, tension and muscle spasm as well as poor posture. Specific treatment and home stretches can improve nerve mobility or reduce nerve irritation.
  • Posture correction may be recommended via specific exercises, posture awareness techniques or taping.

  • Take regular breaks from sustained postures and screen time.
  • Avoiding too much caffeine (including energy drinks)
  • Correct your posture at work with advice from your physical therapist about correct seat, desk and computer height.
  • Change your sleeping position and pillows to ensure good alignment in bed.
  • Learn relaxation techniques, meditation, mindfulness, deep breathing techniques which you can do throughout the day to relieve tension.
  • Regular massage will relief from stress and tension and maintain good mobility and muscle length avoiding the build-up of muscle spasm in your upper back and neck. Massage promotes the release of endorphins – happy hormones – which are proven to reduce stress.
  • Regular physical activity or exercise is excellent in relieving stress and mobilising or strengthening muscles and joints. Exercise has also been proven to release endorphins which can relieve stress and trigger a positive feeling in your body.
  • Attend yoga or Tai Chi classes to relieve stress.

When to see your Doctor

If tension-type headaches disrupt your life or you need to take medication for your headaches more than twice a week, see your doctor.

Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different. Occasionally, headaches may indicate a serious medical condition, such as a brain tumor or rupture of a weakened blood vessel (aneurysm).

When to seek emergency help

If you have any of these signs or symptoms, seek emergency care:

  • Abrupt, severe headache
  • Headache with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties
  • Headache after a head injury, especially if the headache gets worse

N.B. All information contained in this post is for general guidance and information only. It should not be relied as a basis for planning medical care or as a substitute for specialist medical advice in each individual case.

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