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The Pain Behind Tension Headache

Symptoms and diagnosis

By Neurosurgery Singapore

What is a tension headache?

A tension headache is the most common type of headache. It can cause mild, moderate, or intense pain in your head, neck, and behind your eyes. Some people say that a tension headache feels like a tight band around their forehead.

Most people who experience tension headaches have episodic headaches. These occur one or two times per month on average. However, tension headaches can also be chronic. 

What are some symptoms of a tension headache?

Symptoms of a tension headache include:

  • Slow onset of the headache

  • Head usually hurts on both sides

  • Pain is dull or feels like a band or vice around the head

  • Pain may involve the back (posterior) part of the head or neck

  • Pain is usually mild to moderate, but not severe

The pain is usually mild or moderate, but it can also be intense. In this case, you might confuse your tension headache with a migraine. This is a type of headache that causes throbbing pain on one or both sides of your head.

However, tension headaches don’t have all the symptoms of migraines, such as nausea and vomiting. In rare cases, a tension headache can lead to sensitivity to light and loud noise, similar to migraines.

“Tension headaches are the most common type of headache, affecting 30 to 78 percent of the general population. Some people get tension headaches in response to stressful events or hectic days. Tension headaches may be chronic, occurring frequently or every day.”

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What types of diagnosis?

  • Tests which may be used to determine the cause of a tension headache may include:

    • Blood tests. Various blood chemistry and other laboratory tests may be run to check for underlying conditions.

    • Sinus X-rays. A diagnostic imaging procedure to evaluate for congestion or other problems that may be corrected.

    • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

    • Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.

Easing Strategies

  1. Pay attention to the basics. Get enough sleep, don’t skip meals, and be sure to pace yourself to avoid stress and fatigue.
  2. Relaxation techniques. Physical and psychological relaxation therapies can help stave off tension headaches, so long as you practice these techniques regularly. Physical approaches include applying a heating pad to your neck and shoulders to relax the muscles. Exercising these muscles also helps by strengthening and stretching them. Guided imagery exercises that help you focus your attention on various parts of your body in order to relax them and release tension and stress can also help.
  3. Biofeedback. This relaxation technique requires special training but can help people avoid recurrent tension headaches. Our therapist may attach electrodes to your skin to detect electrical signals from your neck and shoulder muscles. You then learn to recognize when you are becoming tense and practice ways to relax the muscles before they tighten so much that you develop a tension headache.
  4. Medical approaches. Some people with tension headaches have very sensitive areas, known as trigger points, at the back of the neck or in the shoulders. Injecting a local anesthetic into these areas may eliminate the pain and prevent the headache from occurring again. There are also a number of medications that can help keep tension headaches at bay. If non-drug therapies aren’t giving you the relief you need, talk with our Neurologist about the medication options that might be right for you.

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