Tension Headaches: Find Information & Specialists

A dull, bilateral pain is the main symptom of tension headaches. Patients often describe the pain as feeling “like being in a vise” or a “ring around the head.” However, the perception of pain varies from person to person, both in terms of intensity and duration.

Tension headaches can be distinguished from migraines based on several factors. With migraines, the pain tends to be one-sided and occurs behind the eyes and at the temples. With tension headaches, on the other hand, there is the “tightness” described above. Furthermore, the symptoms typical of a migraine, such as an aura, tend not to occur with tension headaches.

Like migraines, tension headaches can also cause mild sensitivity to light or sound. However, visual disturbances, nausea, or vomiting do not normally occur with tension headaches.

Although the exact causes of tension headaches cannot be precisely pinpointed, tension in the shoulder and neck muscles is suspected of contributing to them. Experts often consider trigger points, in particular, to be a primary cause.

Trigger points are areas of stiffness in the skeletal muscles. They are not only tender to the touch but can also cause pain in other parts of the body. Trigger points in the shoulder and neck muscles—such as in the trapezius muscle—are particularly likely to lead to tension headaches. When these trigger points are released, the headaches often disappear as well.

Watch the video to see how trigger point therapy works:

In addition, there are other risk factors that can at least contribute to tension headaches. One of these is chronic improper strain on the muscles. This, in turn, can lead to the formation of these very trigger points and to further muscle tension.

Stress is another factor that should not be underestimated. Mental health conditions also frequently play a role in the development of tension headaches.

Genetic predisposition is also a frequently discussed factor.

In summary, the following causes can lead to tension headaches:

• Muscle tension
• Trigger points
• Stress
• Improper posture
• mental health conditions

The diagnosis is made by ruling out other conditions. To do this, the doctor not only performs several examinations but also asks specific questions. These questions may relate to the patient’s general life situation. The doctor also wants to determine whether an injury might have caused the headaches.

In addition, the doctor will ask how the pain feels and when it occurs. If, for example, it occurs only during physical activity, it is unlikely to be a tension headache. Tension headaches are not typically worsened by physical activity.

In addition, the treating doctor may also

• blood tests,
• imaging tests, or
• an EEG

to rule out other conditions.

There is no one-size-fits-all treatment. The doctor always discusses possible treatments with the patient on an individual basis. The patient’s symptoms and triggers—if they can be identified—are key factors in determining the appropriate treatment.

As a first-aid measure, patients with headaches can try to see if

• cold (for example, an ice pack or a small towel soaked in cold water) or
• heat (such as a cherry pit pillow)

provides relief. Peppermint oil (also available as Japanese medicinal plant oil) has also often proven effective as a home remedy. To use it, dab a small drop of the essential oil onto the painful area, such as the back of the neck or the forehead. Be careful not to get the peppermint oil in your eyes or on your mucous membranes, and use only small amounts.

The cooling effect of menthol has a positive impact on headaches and can thus make a headache tablet unnecessary.

Peppermint oil has a cooling effect © unpict / Fotolia

If, for example, muscle tension or trigger points in the muscles are suspected to be the cause, targeted physical therapy can help. However, the release of trigger points can be painful for the patient. This pain is usually short-lived, though, so relief sets in fairly quickly.

In the case of muscular problems, the patient can also take preventive measures. Maintaining proper posture—such as when working in an office—can help reduce muscle tension. A variety of movements in daily life, along with targeted exercises, strengthen the neck and shoulder muscles, making them more resilient.

Unbalanced loads, such as carrying shopping bags or luggage on one side, should be avoided.

Proper sitting posture can reduce muscle tension and, consequently, tension headaches © inegvin / Fotolia

In cases of stress or mental health conditions, specific breathing techniques or relaxation exercises can alleviate stress symptoms. If psychological issues are underlying the tension headaches, referral to a specialist is another option.

Another form of treatment involves the use of medication. It’s important to note that while medication can relieve symptoms, it does not address the underlying causes. However, if tension headaches become unbearable, medication can at least provide short-term relief. However, they are not a long-term solution.

If muscular tension is the cause, the doctor may also prescribe muscle relaxants. However, there must be no contraindications (factors that preclude the use of medication).