What is a Tension Headache?

Tension headaches explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors

Tension HeadachesTension headaches are very common and may be felt in all of the muscles of the face, behind the eyes, at the base of the skull, and in the neck. Tension headaches usually start with pain on both sides of the head and are often periodic or chronic. Extreme pressure around the forehead or head is usually what patients initially feel. Grinding, throbbing, and stabbing pain is also associated with tension headaches in the facial muscles.

Tension headaches may be episodic or chronic. Tension headaches that are episodic may be experienced less than 15 days a month and can last for an hour, but chronic tension headaches develop more often. Tension headaches may be milder than other types of headaches, such as migraines, but they can be stressful and troublesome nonetheless. These types of headaches make you more sensitive to light and sound, may cause you to become irritated more easily, and resulted in impaired concentration.

Causes of Tension Headaches

Hunger, stress, eyestrain, and sleep deprivation are leading factors associated with this type of headache. They are also associated with muscle strain in the temples and the jaws, especially due to issues that arise from clenching or grinding the teeth. Tension headaches are not like migraines because the pain usually affects more than one nerve group like the occipital nerve, the sphenopalatine ganglion, and the trigeminal nerves.

Treatment for Tension Headaches 

Oral analgesics, together with pain-relieving drugs, are often prescribed as part of a treatment regimen for tension headaches. Non-steroid anti-inflammatory drugs (NSAIDs) such as aspirin increase the risk of organ failure if taken too often. Acetominaphen is also an effective treatment for tension headaches, although it may cause liver damage if taken for too long. Carbamezapine is an anticonvulsant that is also effective at treating headaches. These medications can cause serious side effects such as allergic reactions, skin irritation, and organ damage. In addition, antidepressants such as venlafaxine can effectively treat tension headaches.

Biofeedback TherapyAdditional techniques such as acupuncture and biofeedback are also an effective treatment option. Biofeedback is a procedure in which a patient is shown measurements of different vital signs that were recorded during a headache. The recordings include brain activity that is measured through an electroencephalogram (EEG), muscle tension that is visualized through electromyography, and sweat production. However, the readings may be affected by tension and stress. While viewing the recordings, patients can gain a better understanding of the physiological changes that may be causing their headaches, and this can help them learn how to control the headaches through relaxation techniques. Biofeedback may also help patients anticipate the occurrence of tension headaches.

Physical or chiropractic therapy are also helpful treatment approaches. Tension headaches are often the result of muscle strain, therefore, massage or manipulation of the muscles may lead to relief of tension headaches. Both of these techniques have the ability to relieve tension in the affected muscle groups and alleviate stress that may be contributing to the headaches.


Tension headaches are associated with various factors, such as sleep deprivation and stress. Tension headaches may be mild, but can become distressing if they frequently occur and begin to affect concentration and regular activity. Treatment options include massage or chiropractic manipulation to relieve strained muscles. Pharmacotherapy is also commonly utilized to manage tension headaches. These types of medications include NSAIDs, carbamezapine, and acetominaphen. In addition, acupuncture is an effective treatment method as well as biofeedback.

At Pain Doctor our goal is to relieve your headache pain and improve function to increase your quality of life.
Give us a call today at 480-563-6400.


  1. Freitag F. Managing and treating tension-type headache. The Medical clinics of North America. 2013;97(2):281-292.
  2. Krusz JC. Tension-type headaches: what they are and how to treat them. Primary care. 2004;31(2):293-311, vi.
  3. Castien R, Blankenstein A, van der Windt D, Heymans MW, Dekker J. The working mechanism of manual therapy in participants with chronic tension-type headache. The Journal of orthopaedic and sports physical therapy. 2013;43(10):693-699.
  4. Singh NN, Sahota P. Sleep-related headache and its management. Current treatment options in neurology. 2013;15(6):704-722.
  5. Manaka S. [Application of acupuncture as a headache management tool]. Rinsho shinkeigaku = Clinical neurology. 2012;52(11):1299-1302.
  6. Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G, Schoenen J. EFNS guideline on the treatment of tension-type headache – report of an EFNS task force. European journal of neurology : the official journal of the European Federation of Neurological Societies. 2010;17(11):1318-1325.
  7. Bendtsen L, Jensen R. Treating tension-type headache — an expert opinion. Expert opinion on pharmacotherapy. 2011;12(7):1099-1109.