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What is a tension headache? Signs to spot and common causes
Written byAnnabel Francis
Reviewed byHeeral Tomlinson
Ever had a dull, tight headache that won’t shift? Discover what a tension headache is, common symptoms, what causes them and ways to relieve them
Summary
1Tension headache symptoms
Tension headache symptoms can differ from person to person, but typically cause a dull, steady ache or tight band-like pressure around both sides of t
2Tension headache or migraine?
Tension headaches usually feel like constant pressure on both sides of the head, while migraines are more likely to cause throbbing pain on one side.
3How to relieve tension headaches
Tension headache relief often involves simple steps like rest, hydration, relaxation techniques and over-the-counter pain relief.
If you’ve ever had a tension headache, you’re far from alone. Up to 78% of people experience one in their lifetime, with around 26% dealing with them yearly.1 They’re often linked to everyday life – things like stress, poor posture, screen time or lack of sleep – and while they’re usually mild to moderate, they can still be uncomfortable when they strike.
What is a tension headache?
A tension headache is often described as a dull, steady ache rather than a sharp or throbbing pain. Many people say it feels like a tight band or pressure wrapping around the head, rather than pain in one specific spot. Tension headaches can vary in how often they happen and how intense they feel. Clinically, they’re grouped into three types: infrequent episodic, frequent episodic and chronic tension headaches.2
Let’s break these down.
These are the occasional tension headaches that people experience from time to time. They typically happen less than once a month on average, with fewer than 10 headache episodes throughout the year.3 People with infrequent episodic tension-type headaches (TTH) often have long periods without symptoms but can still find them uncomfortable when they do occur. They’re usually mild to moderate and many people find they improve with rest or with over-the-counter options.4
Frequent episodic tension headaches occur more regularly, usually between one and 14 days per month, for at least three months.5 This can add up to between 12 and 180 headache days in a year. Although people may still have headache-free periods, the increased frequency means these headaches can have a greater impact on daily life, especially if triggers like stress, poor posture or disrupted sleep are ongoing. At this stage, identifying triggers and building preventative habits may help reduce how often headaches occur.
Chronic tension headaches are the most persistent form. They occur on at least 15 days per month for over three months, meaning headaches are present on most days of the year.6 This type can feel particularly draining and may interfere with work, sleep and overall wellbeing. If headaches become this frequent, it’s important to speak to a GP, who can help assess symptoms and discuss longer-term management options.
What are the symptoms of a tension headache?
Tension headache symptoms can differ from person to person, but they often include:
- a dull, aching pain on both sides of the head or face7
- tenderness in the affected area which may hurt more when touched7
- feeling like something is pressing on your head or being tightened around it7
- emotional stress can cause muscles in the neck, face, scalp, and jaw to contract8
- unlike migraines, physical activity typically doesn’t worsen tension headache symptoms9
If you feel sick or nauseous, isn’t typical of a tension headache and is more commonly linked to migraines. Please speak to your GP if you do feel sick or unwell alongside a headache or if you’re unclear about your symptoms.
What causes tension headaches?
The exact cause of tension headaches isn’t fully understood, but a number of common triggers have been identified.
Some of the most well-known tension headache causes include:
- stress: high stress levels are one of the most common triggers. Feeling mentally overwhelmed or emotionally tense can cause muscles to tighten, which may lead to a tension headache.10 If you’re looking for ways to reduce stress, there are plenty of techniques or even ingredients that can help support your wellbeing.
- muscle tension: ongoing tightness in the neck, shoulders and upper back can contribute to tension headaches. Poor posture, long periods of sitting, muscle strain or repetitive movements may all play a role.10 Gentle exercises to improve posture and practical tips on caring for stiff joints may help ease tension and support comfortable movement over time.
- eye strain: spending long periods focusing on screens, reading or doing close-up work can strain the eye muscles and increase the likelihood of tension headaches.11
- caffeine intake: both drinking too much caffeine and suddenly cutting back on it can trigger tension headaches in some people. If you’re sensitive to caffeine, keeping your intake consistent may help.12
- sleep patterns: irregular sleep routines or poor-quality sleep can increase the risk of tension headaches. If you’re struggling to sleep, sticking to a regular schedule can be an important part of prevention.13
- dietary factors: certain foods may act as triggers for some individuals. Although limited, research has explored nutritional deficiencies, including vitamin D, and their potential link to tension headaches.14
- environmental factors: some people find environmental factors like bright lights or loud noise can worsen headache symptoms, although these triggers are more commonly linked to migraines.
- hormonal changes: some women may notice headaches occurring more often during hormonal changes, like being on their period or during menopause.15 Understanding your menstrual cycle can help identify patterns and support your overall wellbeing.
How do I know if it’s a tension headache or a migraine?
Because tension headaches and migraines share some symptoms, it can be difficult to distinguish between them.
The differences below can help clarify which type of headache it may be:16
| Migraine | Headache |
|---|---|
| Intense pulsing and throbbing sensation | Constant mild, dull pressure (non-pulsating) |
| Mainly felt on one side of the head | Pressure felt on both sides of the head |
| Nausea | Not common, but may occur with severe tension headaches |
| Symptoms typically worsen with physical activity | Physical activity typically don’t worsen symptoms9 |
| Seeing flashing lights | |
| Blind spots |
How to relieve a tension headache
Tension headache relief often depends on the type and how often they occur:
Infrequent episodic tension headaches
- Relaxation techniques: deep breathing, meditation and progressive muscle relaxation can help reduce stress and muscle tension, which can be effective for managing occasional tension headaches.
- Staying hydrated: dehydration can sometimes make headaches more likely, so drinking enough fluids – especially if you feel a headache coming on – may help.18
- Over-the-counter pain relief: painkillers like ibuprofen or paracetamol may help relieve symptoms on an as-needed basis.9
Frequent episodic tension headaches
If tension headaches start to happen more often, it can help to build on the strategies above and focus on a few longer-term habits.
- Regular exercise: tension headaches are typically more common in people with a sedentary lifestyle. Regular movement – whether that’s walking, stretching or going for a run – can help manage stress and reduce muscle tension, which may lower how often headaches occur. 4 Activities that support flexibility for muscle strength may be helpful, and even simple habits like understanding how many steps you should do a day can make a positive difference over time.
- Adequate sleep: sleep is important to your health and poor or irregular sleep can make tension headaches more likely. Sticking to a consistent sleep schedule and prioritising good sleep hygiene may help reduce the frequency of headaches over time.13
Chronic tension headaches
If tension headaches become very frequent or long-lasting, it’s important to seek medical advice. A GP can help explore treatment options and support you in managing symptoms more effectively.
- Preventative medication: these medications are used to reduce how often headaches occur, rather than treating pain once it starts. Your GP can help decide whether this approach is suitable and advise on the most appropriate option.4
- Physiotherapy: a physiotherapist can assess your posture, muscle tension and movement patterns. They can then recommend targeted exercises or recovery techniques to correct them, which may help reduce headache triggers.
- Acupuncture: NICE guidelines suggest that a course of up to ten acupuncture sessions may help reduce the frequency of chronic tension-type headaches for some people.19
Tension headache FAQs
The NHS recommends using a warm flannel on the back of the neck or a cool flannel on the forehead to help ease tension headaches.7
Many people find massage relaxing, and it can be a helpful way to de-stress and ease the symptoms of some tension headaches.7
Tension headaches don’t typically cause dizziness. They’re more often described as a steady, pressing pain, without symptoms commonly linked to migraines like nausea or visual changes.20 If you suffer with these symptoms often or they feel severe, it’s important to speak to a GP.
Tension headaches can last anywhere from 30 minutes to several hours, although in some cases they may continue for a few days. They’re usually described as a steady, dull pressure rather than severe pain. If headaches last a long time, happen frequently or start to affect your daily life, it’s a good idea to speak to a GP.
The final say
If you deal with tension headaches from time to time, you’re not alone – they’re incredibly common and often tied to everyday things like stress, posture and sleep. The good news is that small habits can make a difference and finding ways to unwind may help. Paying attention to triggers, building in regular movement and rest, and using occasional pain relief when needed can all help you feel more in control. And if headaches become more frequent or start affecting your daily life, it’s always worth speaking to a GP for personalised advice and support.
Disclaimer – This article provides informational advice and is not a substitute for medical care. Working with experts for accuracy, we take great care to ensure the information is up-to-date and relevant. However, you should always consult your GP or healthcare professional before using supplements or alternative products, particularly if you have medical conditions or are under supervision.
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3. Ashina, S., Mitsikostas, D.D., Lee, M.J. et al. Tension-type headache. Nat Rev Dis Primers 7, 24 (2021). https://doi.org/10.1038/s41572-021-00257-2
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