Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

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Am Fam Physician. 2005;72(9):1815

What are tension headaches?

A tension headache is a dull, achy feeling on both sides of the head. Some people with tension headaches also have a tight feeling in their head or neck muscles. Tension headaches start slowly, usually in the middle of the day. Another name for this type of headache is “stress headache.” Tension headaches can be mild or very bad. Sometimes they hurt more than migraine headaches.

How are tension headaches diagnosed?

Your doctor usually can tell what kind of headache you have by examining you and hearing you talk about the pain. Blood tests, x-rays, or brain scans usually are not needed.

How are tension headaches treated?

If you have tension headaches only once in a while, an over-the-counter medicine probably can help. Check the medicine’s label for possible side effects and to see if it’s safe to take with other medicines. Always read and follow the directions on the label carefully. If you have any questions, ask your doctor or pharmacist.

If you have tension headaches almost every day or if over-the-counter medicines don’t help your pain, you should see a doctor. He or she may prescribe some medicine that you take only when you have a headache. It’s best to treat tension headaches when they begin, before they get more painful.

Your doctor also may prescribe a medicine that you take every day, even when you don’t have a headache. This medicine may help keep you from getting tension headaches. If your tension headaches don’t get better, or if they get worse, you should see your doctor.

What else can I do to help with the pain?

Here are some other things you can do to help your headaches:

  • Put a heat pack or an ice pack on your head or neck

  • Take a hot shower

  • Get enough sleep

  • Take time away from things that are stressful. This could mean doing anything from taking a brief walk to going on a long vacation

  • Get regular exercise of all types. Work up to exercising for 30 to 60 minutes, four to six times a week.

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