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Guide to Tension-type headache

What is a Tension-type headache?

Tension-type headache is generally a diffuse headache, ranging from mild to moderate pain in your head that is often described as feeling a tight band around your head. This headache is the most common type of headache and its causes are not yet fully understood.

What causes a Tension-type headache?

Tension-type headache does not yet have an exact cause, but the most common causes that has been theorized are general stress, lack of rest or sleep. Some more causes include muscular stress, prior neck injuries and possible postural imbalances.

How is a Tension-type headache diagnosed?

Tension-type headaches typically present with the following symptoms:

  • Pain that is described as tight/squeezing or pressure-like
  • Pain is across the head and is felt on both sides
  • Lasts 30min to 7 days
  • Not aggravated by physical exercise
  • Tenderness on your scalp, neck and shoulder muscles

The diagnosis of tension-type headache will require a physical examination of the neck following a comprehensive detailed history of the symptoms that you are experiencing. A physical examination will involve palpation of tender muscles in the neck and shoulder region, assessment of your range of motion and palpation of your neck joints.

How is a Tension-type headache treated?

Tension-type headache has several different treatment modalities that can help reduce the frequency and intensity of the headaches. Myofascial trigger point therapy in hypertonic muscles in the neck and shoulders which commonly refer pain into the head. Manipulation to the joints higher up in the neck where muscles attach has benefits in stimulating the muscles. Posture and ergonomic evaluation are very important in preventing re-occurrence and frequency of these headaches if it as a result of muscle tightness and referral.


Vizniak, N., Carnes, M. and Vizniak, N., 2007. Quick Reference Conservative Care Conditions Manual. Vancouver: Professional Health Systems.

The Journal of the American Osteopathic Association, April 2005, Vol. 105, 16S-22S.

Page, P. (2011). CERVICOGENIC HEADACHES: AN EVIDENCE-LED APPROACH TO CLINICAL MANAGEMENT. International Journal of Sports Physical Therapy, [online] 6(3), pp.254–266. Available at: [Accessed 1 Dec. 2020].

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