Headache is the most common pain known to humans. For many of us a headache is a minor thing, easily ignored or relieved with the usual aspirin or with balm. But not all headaches are alike. Some can be so frequent and so severe that the sufferer cannot function in daily activities. Many headaches are due to physical problems but ninety percent of all headaches are ‘tension headaches’.

How to recognize a tension headache

  • Pain in a tension headache is in the head and neck and the following are some of the terms people use to describe them :
  • It gives rise to stiffness in the head and neck
  • It is a steady ache
  • Gives a feeling of pressure and tightness in the head
  • The location of the pain shifts a little each time, but usually it affects both sides of the head spreading to forehead.
  • The pain becomes more severe during the afternoon and evening

A tension headache may be accompanied by other symptoms such as :

difficulty in concentrating, anxiety, depression, sleep disturbances, poor appetite, dizziness, weakness, tirednessA tension headache not only occurs during a stressful situation but it can occur if the person is expecting a stressful situation. It can awaken a person from sleep or begins on waking up.

The causes of tension headaches

The pain of these headaches is due to stress and anxiety which causes the muscles of the head and neck to tighten up. The tightened muscles pull and stretch tissues and this leads to the ‘pressure sensation’. The stress which causes these headaches will vary from person to person, but family and marital problems, money problems and job stress apart from internal conflicts are obvious triggers. People with tension headaches worry that it may be due to some terrible illness. This worry naturally, only adds to the pain.

Differentiation from other headaches :

If the headaches are accompanied by vomiting, blurring of vision, loss of function of a body part or is one sided it is not a tension headache and is a Vascular headache. Similarly headache may be due to sinusitis, head injury or trumors and infections of the brain. These headaches are accompained by neurological symptoms.

Treatment of tension headaches

The physician or neurologist needs to rule out other causes of headache through history, physical examination or investigations.

Life is full of stresses and it is impossible to ensure that stress does not occur. The best we can do is to cope with it better.

Here are some suggestions for someone with tension headaches :

  • To reduce stress, work through some of your problems and make out action plans for dealing with them. Acting instead of worrying will not only prevent the pain, it will reduce the stress itself.
  • If the headache is not prevented, the best treatment for it is some form of deep relaxation therapy. This can be achieved through Yoga or meditation, or through the Progressive Muscular Relaxation method which can be taught by psychiatrist or psychologist. Machine assisted biofeedback or electrosleep are also very useful.
  • The psychologist or psychiatrist may begin a program of Behavior therapy in which the sufferer can be taught better techniques for coping with situations which create anxiety for him or her.
  • In cases where the headaches go on for days, the therapist may find it advisable to involve the family in therapy, helping them to cope with problems better and giving them guidelines on how to support the patient.
  • In some cases, where it is not clear whether the headache is of the tension headache variety, the doctor or psychiatrist may consider it worthwhile testing for the presence of other psychological problems.
  • In some cases the psychiatrist may consider giving medication for the problem which can start reducing the anxiety followed by better control by other psychological techniques.
  • Treatment for tension headaches is often helpful even with headaches of the migraine variety which are usually co-existent or precipitated by stress.

Some words of caution

Medication for headache only works for a short while because one gets used to the medicine very rapidly, after which it doesn’t work so well. Alcohol although found by some to relieve the headache temporarily only increases it further.

Consult the psychiatrist if your physician tells you that your headaches are due to tension, if they are frequent and severe, or disrupt your daily functioning and if the usual pain killer don’t help.