Tension Headaches

Finally, the last of the three types of headaches suffered by women…Tension headaches. Tension headaches are common, nonspecific headaches that are not caused by underlying disease. Because they affect 40 percent of the population at some time, they are often considered to be “normal” headaches.

Tension headaches fall into two general categories: episodic (occurring less than 15 times per month); and chronic (15 or more headaches per month).

Tension headaches often start in the afternoon or early evening, typically building in intensity over time. The chief symptom is usually a sense of tightness around the head – the “tight hatband” or “vise” sensation. Neck and shoulder muscles are often tense and sore to the touch. Other symptoms may include trouble concentrating, difficulty sleeping, and an increase in headache pain when there is noise or bright light.

If severe or unusual headache pain brings you to your doctor’s office, he or she will want to determine exactly what type of headache you are experiencing. Your doctor will ask you about:

  1. The frequency of your headaches (how often they occur) 2. The timing of your headaches (what time of day they start) 3. The headache triggers (what makes the headache begin) 4. The duration of your headaches (how long they last) 5. The headache location (what part of your head is involved) 6. The quality of the pain (whether the pain feels steady or throbbing) 7. What make the pain feel better or worse 8. The presence of other, associated symptoms (nausea, vomiting, sore muscles, insomnia, difficulty concentrating)

There is no specific test to confirm the diagnosis of a tension headache. Your symptoms, your medical history and a physical examination determine the diagnosis by your doctor. In some patients, a computed tomography (CT) scan of the head may be needed to investigate headache pain that is either constant or associated with atypical (unexpected or unusual) symptoms.

An episodic tension headache may last only a few hours or it may linger for a day or more. A chronic tension headache typically persists through a 24-hour cycle, although there may be fluctuations in pain intensity during that time.

To help prevent tension headaches you can:

Maintain good posture to prevent the muscle cramps that can lead to tension headaches.

Follow a program of frequent, regular exercise, especially one involving aerobic exercises such as running or cycling.

Exercise can prevent tension headaches from forming.

Practice relaxation techniques.

For episodic tension headaches that occur less than three times weekly, over-the-counter pain relievers such as aspirin, acetaminophen or ibuprofens are convenient and effective. Combination products whose formulas combine pain medication with caffeine may be most beneficial. An ice compress or a heating pad can also be extremely helpful, or a massage to any tight areas in the neck and shoulders. Relaxation techniques, such as deep breathing exercises or biofeedback and acupuncture may help decrease the frequency of headaches. Chronic tension headaches that occur daily may require treatment with a prescription.

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