What is it?
With tension headache you feel a pressing or tight pain on both sides of your head, like a band pulled tight around it. The muscles in your neck and shoulders are often stiff or sore. It rarely makes you feel sick.
An episode lasts from half an hour to a few days. If you have had headache on 15 or more days a month for over three months, doctors call it chronic tension headache.
Sometimes a headache comes from the neck itself. Your neck then moves less far and certain neck movements set off the headache; doctors call this cervicogenic headache.
Common causes
- Pain signals from tense neck and shoulder muscles
- A nervous system that becomes more sensitive after long or frequent headaches
- Taking painkillers too often
- A problem in the neck joints (cervicogenic headache)
- Stress, although its role is unclear
How we diagnose
We ask where the pain is, how often it comes, how long it lasts and how many painkillers you take. A headache diary helps show the pattern. Your physiotherapist examines how your neck moves and whether neck movements set off the headache.
If your story fits migraine better, or we see warning signs, we refer you to your GP.
Treatment approach
The foundation is in your own hands: enough sleep, daily exercise and painkillers for no more than a few days in a row. Physiotherapy makes sense when the headache keeps coming back and that advice is not enough.
You learn to relax your neck and shoulder muscles and stay active, with exercises for strength and posture. We mainly choose an active approach with exercises and advice.
Expected recovery
The pace differs from person to person. Together we set goals and use your diary to track whether the headaches come less often or less severely.
If you see no improvement after a few weeks, we discuss whether your GP can offer other help, such as relaxation therapy or behavioural therapy.
