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Tension Headache - Information Review
Last reviewed: 07.07.2025
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Tension headache is the predominant form of primary headache, manifested by cephalgic episodes lasting from several minutes to several days. The pain is usually bilateral, squeezing or pressing in nature, mild to moderate in intensity, does not increase with normal physical activity, is not accompanied by nausea, but photo- or phonophobia is possible.
Lifetime prevalence in the general population, according to various studies, varies from 30 to 78%.
Synonyms: tension headache, psychomyogenic headache, stress headache, psychogenic headache, idiopathic headache.
Symptoms of tension headaches
Tension headache is a non-incapacitating, diffuse headache without nausea or photophobia, which are characteristic of migraine.
Episodic tension-type headache is quite common; most patients experience relief with over-the-counter analgesics and do not seek medical attention. Many patients with frequent tension-type headaches may also develop migraine attacks; tension-type headache may be a form fruste of migraine. Frequent tension-type headaches may be associated with depression, sleep disturbances, and anxiety disorders.
Chronic tension headaches are frequent or prolonged episodes of low-intensity headaches lasting from several hours to several days. The pain is most often characterized as pressing or squeezing, beginning in the occipital or temporal regions and then spreading to the entire head. Tension headaches are usually absent in the morning upon awakening and intensify during the day.
Where does it hurt?
Diagnosis of tension headaches
The diagnosis of tension headache is made on the basis of a characteristic clinical picture in the absence of data for CNS pathology based on the results of an objective examination (including a neurological examination). Potential provoking factors of chronic tension headache (in particular, sleep disturbance, stress, dysfunction of the temporomandibular joint, neck pain, visual fatigue) should be identified and eliminated.
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Who to contact?
Treatment for tension headaches
Migraine prophylaxis medications, particularly amitriptyline, prevent chronic tension headaches. Given the generally excessive use of analgesics for this type of headache, it is important to use behavioral therapy and psychological interventions (e.g., relaxation, stress management techniques).
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