Tension-type headaches are the most common headache disorder and usually symptoms include feeling a tight band or pressure around your head and / or neck, with symptoms lasting anywhere from several hours to several days. These headaches range from mild to moderate in intensity and don’t have any of the associated symptoms which are found in migraines. If you suffer from these headaches you will most likely know that they can lead to missed workdays and hugely affect your day to day activities. These headaches are characterised by how often you experience them in each month. If you experience tension-type headaches 14 or less days out of 1 month then it is considered episodic in nature, if 15 or more days out of a month for 3 consecutive months then it is considered chronic in nature.

Episodic tension headaches are common and are reported by more than 70% of some populations, whilst chronic tension headaches tend to only affect 1-3% of adults. Tension headaches usually begin in the teenage years and you are at highest risk of experiencing them between the ages of 30-39.

Sadly, it is largely unclear as to what causes tension headaches. The current hypothesised theory is that these headaches are the result of neurotransmitter (chemical within the body which acts as a messenger between different bodily structures) imbalances. It is likely that there is an association between muscle tightness in the upper back & neck which contributes to this neurotransmitter imbalance but this has not been scientifically proven. The mechanism tends to be a combination of stress related factors associated with musculoskeletal problems in the neck such as muscle tightness / weakness / stiffness.

Every person who suffers from tension type headaches will have different triggers but the following tend to be common triggers: stress, eye strain, over exertion, hormonal changes, depression, anxiety, sleeping in an awkward position and holding your head in one position for a long time.

So, we have briefly described the key information regarding tension type headaches, now onto discussing the medical & physiotherapy management.

As the specific cause of tension headaches is still largely unknown it makes managing the condition difficult. However, it has been found that over the counter analgesics such as ibuprofen are more effective than paracetamol. Before starting or changing your medication for tension headaches, speak to your pharmacist / GP to ensure that it is safe to do so.

Physiotherapy management for tension headaches will include one or a combination of the following techniques:

• Stretching & strengthening exercises for the neck & upper back
• Acupuncture / acupressure points
• Spinal mobilisation & manipulation
• Deep tissue massage & trigger point therapy
• Heat & ice packs
• Tracking a headache diary to analyse triggers

Tension type headaches are a common condition and it’s not worth pursuing the ‘wait & see approach’ in the hope that they will suddenly settle down. Therefore, come book in for your complimentary physiotherapy consultation or sports massage taster session to see how we can help reduce your pain and best manage your tension headaches!