The most common form of headache is a tension headache. It usually goes by itself. The headache may be due to tense muscles, but it can also have other causes. The pain can often be triggered by anxiety, stress, and lack of sleep.

Tension headaches usually start when you are between 20 and 40 years old, but even children can get it. The name tension headache comes from the fact that it was previously thought that it was tense muscles around the skull or in the neck that causes the headache. But not everyone gets tension headaches that have tense muscles.

Symptoms of tension headache

Tension headaches can be felt as a tightening band over the forehead or head. It can also feel like something is weighing from the top. Sometimes it feels like you have a too narrow cap. The pain can also sit in the neck, in the jaws and temples.
Here are some common symptoms of tension headaches:

  • You get a dull, grinding or pressing pain in the head. The pain is not usually cutting, chopping or pulsating.
  • The pain is often felt on both sides of the head.
  • The pain returns in periods that last from hours to days.
  • The pain is easy to moderate. It can vary but often gets worse during the day.
  • The pain usually does not get worse by physical exertion but is relieved instead. But some may experience increased headaches from vigorous physical exertion.

Chronic tension headaches mean that you have tension headaches for more than 15 days a month for longer than half a year. For chronic tension headaches, the following symptoms are common:

  • You have sore points in the scalp or neck, and sometimes in the jaw muscles.
  • You feel tired, have dizziness, earache, memory problems and difficulty concentrating.

When and where should I seek care?

The vast majority of people who get headaches do not need to seek care because the problems often go away on their own. But sometimes you may need to seek care, for example, if the headaches are severe or prolonged.

Contact a health care provider  if you have any of the following:

  • You have had headaches before, but now it has changed its character.
  • You have had daily headaches for more than a week.
  • You use medicines for headaches several times a week.
  • You have headaches that increase and become stronger and come more often.
  • You have a headache, are over 50 and have not had tension headaches before.
  • You have headaches that interfere with everyday life.
  • You get symptoms of tension headaches other than those that are typical of tension headaches.

If it is a weekend, you can wait until it is every day. You can contact many receptions by logging in.

If it’s in a hurry

If  you have one or more of the following problems, please contact a health care center or an on-call reception immediately :

  • You have had a blow to the head and after that have had a headache and feel lethargic.
  • You suddenly have an intense headache.
  • You have a headache while you have a fever and are stiff in the neck.

If it is closed at the health center or on-call reception, seek care at an emergency room.

What can I do for myself?

There is much you can do yourself to prevent and relieve tension headaches. Depending on what causes the headaches, any of the following may help:

  • Try to reduce the stress in your life. Many people get headaches from stress.
  • Change bad postures.
  • Examine the vision of an optician. Headaches can sometimes be because you look bad. Then it can help if you get glasses.
  • Moving on You The pain does not get worse, but can, on the contrary, be alleviated by your physical exertion.
  • Take non-prescription medicines for pain if headaches are mild.

Write down when the trouble comes in a headache diary

For recurring headaches, it is good if you learn to recognize situations that may contribute to your headaches. Then you can eventually learn how to prevent headaches.

For example, these things might be good to include:

  • What date and time are the headaches going on?
  • How does the pain feel?
  • What relieves the pain and what makes it feel worse?
  • What drugs did you take for the pain, and at what dose?

Important to practice relaxation

Those who have tension headaches often have tense muscles without knowing it. Then it is good if you learn to relax. Often it requires that you take the time and that you start with new routines to make it better. Relaxation exercises and exercises in mindfulness can be helpful. Some are relaxed by, for example, yoga or massage, while others are helped by long walks and getting out into the fresh air.

Sometimes it can be good to rest from too much impression. You should also make sure that you drink enough water.

Physical exercise, good posture, and sleep

The muscles can become stiff if you have been tense in your body for a long time. You can prevent it by moving around. Movement increases blood circulation strengthens the neck muscles and back muscles. In this way, posture can also be improved and the neck relaxed. You who have a sedentary job should vary your posture. Remember to always have good lighting when working and reading. Do an eye exam and get glasses if you look bad. It may be particularly important to take breaks frequently if you are working or sitting in front of a computer screen.

Try to have regular sleep habits and make sure you get enough sleep.

Prescription-free medicines for tension headaches

You can relieve tension headaches by using non-prescription and pain-relieving drugs. Examples are drugs containing paracetamol and drugs belonging to the NSAID group, or cox inhibitors.

Here you can read about which prescription drugs are available and which may be suitable for you.

These drugs only provide temporary help. Therefore, they should not be used for an extended period or too often. Use these drugs at most 2-3 times a week, as they can also aggravate headaches. Always write down what medicines you are taking, how many and when you took them.

Investigations

At a doctor’s visit, it is good if you can tell as much as possible about the pain. You can usually answer the following questions:

  • When did you have headaches in recent times? Enter the time of day and weekday if you can.
  • Do you have different types of headaches, such as both migraine and tension headaches?
  • Did the pain come suddenly, like a seizure or did it come slowly?
  • How long did the pain last and how intensely did it feel?
  • Where in the head did the pain feel?
  • Have the headaches changed?
  • Do you use medicines for headaches? Does it help? How often do you usually use this medicine?
  • Are there other things that relieve or aggravate the pain, for example, certain activities, situations or certain food, drink, fatigue, stress or anxiety?

After the call, your blood pressure is measured and the doctor does a thorough examination of the body. What is being investigated is the upper back, especially the neck, neck muscles, jaw muscles, nasal sinuses, eyes, heart and lymph nodes. Sometimes you can also submit samples.

Treatment for Tension Headaches

Tension headaches usually go away by themselves. But sometimes the pain is severe and lasts for a long time. In case of more severe pain, you can sometimes get prescription drugs. Be careful with medicines because you may get headaches from using too much.

Sometimes the drugs do not provide adequate help. Then you may need to try another treatment for tension headaches, such as physiotherapy treatment, ie physiotherapy. You can also get treatment with psychological methods. Such treatment can be especially good for those who have had a long-term headache that often comes, ie several times a week. 

Treatment with physiotherapy

Treatment with physiotherapy can be good if the headaches are caused by the muscles being tight in the head or neck. For example, it may depend on how you sit or hold your head. The purpose of the treatment is then that you should improve your body consciousness, often combined with physical exercise.

Relaxation training often has a good effect

Relaxation training often provides good help to relieve the pain in tension headaches. It aims to teach you how to reduce the experience of stress and headaches. This is done by practicing a method that provides quick relaxation when the headaches begin to feel. The method that should be given by a psychologist has been shown to reduce the strength of the pain and how often the headaches come. It has also been shown that the improvement continues after completion of treatment.

Treatment with KBT

Cognitive-behavioral therapy (KBT) in headaches can help you reduce negative thought patterns in headaches. This can, for example, apply to so-called disaster thoughts, such as “now the headaches are coming again and I can’t do anything about it”.

With KBT you are supported in being able to keep your usual activities in everyday life as much as possible.

Self-help on the internet

There are also self-help programs for headaches on the internet. These programs are usually based on psychological methods that have proven to be of good help in traditional therapy by a therapist, such as relaxation training and KBT. You buy and follow a program through the computer. This means that you are active yourself and follow the program for a certain period, usually a few months. The result is often best if you also have contact with a psychologist with knowledge about self-help programs. The psychologist can then support and help when problems arise during treatment.

Important with medical examination before treatment

Before you begin treatment with a physiotherapist, psychologist or the Internet, it is important that a doctor first perform an examination. It is to rule out that a physical illness causes headaches.

Influence and participate in your care

You can seek care at any medical center or open specialist clinic you want throughout the country. Sometimes a referral  to the open specialist care is required.

You should understand the information

In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. For example, you should receive information about treatment options and how long you may have to wait for care and treatment.

Ehtisham Nadeem

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