Pop quiz: What’s the most common type of headache? Surprisingly, it’s not a migraine. Tension headaches take the prize for the most common headache disorder. Neurologist Emad Estemalik, MD, talks tension in this Q&A:
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Q. What is a tension headache?
A. People describe tension headaches as an aching pain that affects both sides of the head. They can last 30 minutes or linger for a few days. Typically, pain is the main symptom. Common migraine symptoms such as nausea, vomiting or light sensitivity aren’t usually factors for a tension headache. (Yay?)
“The biggest trigger for tension headaches, and probably the reason they are so common, is stress,” says Dr. Estemalik. “In most cases, lifestyle tweaks that reduce stress are enough to keep tension headaches at bay.”
Q: Who’s more likely to get tension headaches?
A: Men and women, young and old, are all equally at risk. The most significant cause is feeling stressed or overwhelmed — so a person who has a high-stress job or works long hours may be more susceptible. And people who are prone to depression, anxiety or sleep disorders are also more likely to experience tension headaches.
Q: Are there different types of tension headaches?
A: We categorize tension headaches as episodic or chronic. Episodic tension headaches are milder, less frequent and relatively short-lived.
If someone reaches a threshold of 15 headache days a month, or realizes their headaches are affecting their life quality, we would label those as chronic tension headaches.
Q: How can I get relief from tension headaches?
A: A tried-and-true home remedy for both chronic and episodic tension headaches is using a hot or cold compress to alleviate the discomfort. Place it on the forehead or over the neck and shoulders.
People can easily manage episodic headaches with over-the-counter (OTC) pain relievers like a nonsteroidal anti-inflammatory drug (NSAID) and acetaminophen. We recommend people limit the use of OTC pain relievers to two times per week at most. Using them too often could result in medication-overuse headaches, plus too much could damage the kidneys or liver.
People with chronic headaches may need daily prevention medicines. But we have a lot of options to help people avoid tension headaches altogether.
Q: Can tension headaches be prevented?
A: Yes! Because of their strong link to stress, take these steps to prevent or minimize the severity of tension headaches:
- Drink water: Dehydration can increase headache severity, so drink eight glasses of water each day.
- Exercise: Physical activity produces brain chemicals (endorphins) that are natural painkillers. Exercise also leads to improved sleep.
- Gentle stretches: Yoga and tai chi both blend relaxation, breathing and stretching to reduce stress levels.
- Good sleep hygiene: Improve your sleep by minimizing daytime naps, avoiding caffeine or alcohol close to bedtime, getting exercise and avoiding electronic devices before bed.
- Massage: Whether you prefer a light touch or deep-tissue work, massage helps relieve built-up muscle tension in the shoulders, neck and scalp.
- Mindfulness: Using your breath as a guide to keep your thoughts in the present can help reduce overall stress and pain.
Q: How do I know if my headache is a sign of something more serious?
A: The most common fear I hear is that headaches are a sign of a brain tumor or other problem. You don’t have to worry unless your headache comes with numbness or tingling, facial droop, or vision or cognitive changes. But if you’re over age 50 and only just starting to experience headaches, talk to your doctor.