Benign Tension Headache

What Is It?

A tension headache, also known as benign headaches, stress headache or a benign tension headache, is by far the most common type of headache. It is known as a tension or stress headache because it is often associated with emotional stress or tension. Often described as a tightening feeling around the head, this common headache causes widespread mild to moderate pain that can affect almost any part of the head.

The "benign" part of the name refers to the fact that these headaches are typically just a nuisance, not a major medical problem. Unlike other rare types of headaches that can be associated with significant disease (such as brain tumor headaches, meningitis headaches and subarachnoid hemorrhage headaches), they are not usually associated with any significant underlying medical condition. In fact, most individuals experience one or more tension headaches in their life at various times.

Little is known about what causes tension headache. However, they are often associated with emotional stress. People with work-related or emotional stress often have more frequent headaches. They can also be associated with eye strain and concentration such as with prolonged use of a computer with intense staring at the computer screen. Likewise, they are associated with awkward body positioning and holding one position for a long time. Tensing the jaw, depression and anxiety can also all trigger a headache.

What Types of Symptoms Are Typical?

The benign tension-type headache is usually described as a dull, aching pain in the head. The pain is often described as tightness or pressure which can run across the forehead, the sides or back of the head. Occasionally, tenderness of the scalp and neck and shoulder muscles is also noted and some sufferers loose their appetite during a headache.

These headaches can be quite variable in their intensity, from a mild nuisance to a more moderate to severe pounding pain. They can also vary in length, lasting from only minutes to several days. In those patients who have chronic, frequent headaches of the tension-type, it can be confusing to distinguish these from migraine headaches. However, migraine headache symptoms often include other things that help to distinguish them. For example, tension headaches do not typically causes symptoms such as visual disturbances (scotoma or flashing lights)and nausea and vomiting, all of which can be common with migraine.

How Is The Diagnosis Typically Made?

Because stress headaches are not related to any underlying medical condition (such as a tumor, hemorrhage, infection or other pathology) there is not test or study which can make the definitive diagnosis. However, tension-type headaches are common and rarely associated with other symptoms. Therefore, most patients who have a mild to moderate headache are assumed to have this type of headache.

However, when a person presents with a headache with other characters or features, such as a change in level of consciousness, nausea and vomiting, or other neurological symptoms, to name a few, then a work up may be done to rule out other types of headaches which may have different treatment or prognosis. In particular, any signs of life-threatening causes (such as a sudden onset severe headache and loss of consciousness, deteriorating level of consciousness, high fever, neck stiffness, etc.), such as a subarachnoid hemorrhage, meningitis or brain tumor, should be worked up by a physician to determine the underlying cause and appropriate treatment.

What Are Some Common Treatments?

Fortunately, treatment of common stress headaches is generally effective. First and foremost, lifestyle and other non-medical management can help in many cases. For example, relaxation, massage, exercise, improving posture, deep breathing and meditation can help to alleviate the stress and tension associated with these headaches.

Additionally, many over-the-counter medications are available for treatment of headache. Basic non-steroidal analgesic medications such as aspirin, ibuprofen, naproxen and tylenol can all be used and are often effective. Some medications, such as Excedrin, combine these drugs with caffeine. More potent medications are sometimes available by prescription. However, opiate-containing pain medications like morphine, vicodin, percocet and others are rarely recommended because of their side effects and potential for dependency. For chronic sufferers, some medications, such as tricyclic antidepressants and serotonin selective reuptake inhibitors (SSRIs), may be used that help prevent recurring headaches.

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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