Tension headache Health Article

Signs and tests

A headache that is mild to moderate, not accompanied by other symptoms, and responds to home treatment within a few hours may not need further examination or testing. If a neurologic (nervous system) examination is performed, a tension headache causes no abnormal findings. However, tenderness in the muscles near the skull is often present.

The health care provider should be consulted -- to rule out other disorders that can cause headache -- if the headache is severe, persistent (does not go away), or if other symptoms happen with the headache.

Headaches that disturb sleep, occur whenever the person is active, or that are recurrent or chronic may also require examination and treatment by a health care provider.

Treatment

Understanding your headache triggers can help you avoid situations that cause your headaches. A headache diary can help you identify your headache triggers. When you get a headache, write down the day and time the pain began. The diary should include notes about what you ate and drank in the last 24 hours, how much you slept and when, and what was going on in your life immediately before the pain started. For example, were you under any unusual stress? Also include information about how long the headache lasted, and what made it stop.

Hot or cold showers or baths may relieve a headache for some people. You may need to make lifestyle changes if you have chronic tension headaches. This may include getting plenty of sleep and exercise, stretching the neck and back muscles frequently, and possibly changing your job or recreational habits.

Over-the-counter painkillers such as aspirin, ibuprofen, or acetaminophen may relieve pain if relaxation techniques do not work. If you are planning to take part in an activity that you know will trigger a headache, taking one of these painkillers beforehand may be helpful.

An antidepressant or other medication may be advised for chronic tension headache. A nonsedating muscle relaxant like metaxalone (Skelaxin) helps some patients. In severe cases, the combination of butalbital and acetaminophen (Fioricet) or butalbital and aspirin (Fiorinal) may be helpful.

Tricyclic antidepressants such as amitriptyline, nortriptyline, doxepin taken every day may help decrease the number or prevent the headaches.

Expectations (prognosis)

Tension headaches usually respond well to treatment without residual effects. They are annoying, but not dangerous.