Triggers and aggravators
There are many possible triggers of tension headache. You may have no identifiable or consistent trigger, or have several obvious ones. Potential triggers include:
* Stress
* Depression and anxiety
* Lack of sleep or changes in sleep routine
* Skipping meals
* Poor posture
* Working in awkward positions or holding one position for a long time
* Lack of physical activity
* Occasionally, hormonal changes related to menstruation, pregnancy, menopause or hormone use
* Medications used for other conditions, such as depression or high blood pressure
* Overuse of headache medication
Half the people with tension headache report that they felt stressed or hungry before their headache began.
Tension headache may be made worse by jaw pain from clenching or grinding teeth (bruxism) or by head trauma, such as a blow to the head or whiplash injury. People with stiff joints and muscles due to arthritis of the neck or inflammation of the shoulder joints may develop tension headache.
Self-care
Rest, ice packs or a long, hot shower may be all you need to relieve a tension headache. A variety of nonmedication strategies can help reduce the severity and frequency of chronic headaches. This approach can be a vital part of any treatment plan for headache. Try some of the following suggestions to see which work best for you.
Healthy lifestyle. Behaviors that promote general good health also may help prevent headache. These lifestyle measures include following regular eating and sleeping schedules and avoiding excess caffeine. It's also important to stay physically active. Regular aerobic exercise, such as walking, swimming or biking, can help reduce the frequency of tension headache. If you already have a headache, exercise may help relieve the pain. But be sure to talk to your doctor before starting any exercise program.
Stress management. Stress is a commonly reported trigger for tension headache. One way to help reduce stress is by planning ahead and organizing your day. Another way is to allow more time to relax. And if you're caught in a stressful situation, consider stepping back and allowing emotions to settle. A variety of relaxation techniques are useful in coping with tension headache, including deep breathing and biofeedback. If anxiety or depression is an issue, behavior therapy may be helpful for dealing with stress and pain.
Muscle relaxation. Muscle tension is associated with tension headache. Applying heat or ice to sore muscles may ease the tension. Which treatment to apply is a matter of personal preference. Some people find heat more effective, while others prefer cold. If heat is your choice, you may use a heating pad set on low, a hot-water bottle, a warm compress or a hot towel. A hot bath or shower also may help. If cold is your choice, wrap an ice pack in a cloth before use to protect your skin.
Massage is a wonderful way to relieve muscle tension. For some people, it may also provide relief from headache pain. Gently massage the muscles of your head, neck and shoulders with your fingertips. Or have someone else do the massage for you.
Perfecting your posture. Good posture can help keep your muscles from tensing up. It places minimal strain on your muscles, ligaments, tendons and bones. Good posture supports and protects all parts of your body and allows you to move efficiently. When standing, hold your shoulders back and your head high. Pull in your abdomen and buttocks and tuck in your chin. When sitting, make sure your thighs are parallel to the ground and your head isn't slumped forward.
Try to avoid sitting, standing or working in one position for long periods of time. Wearing poorly fitting shoes or high heels also can cause posture problems. Do regular stretching and strengthening exercises for your neck and shoulders. Here are other tips for improving your posture:
- Stand with your weight on both feet.
- When standing in one place, put one foot up on a stool or chair rung and switch to the other foot periodically.
- Don't carry a shoulder bag that weighs more than 2 pounds.
- Sit in a straight-back chair with your back supported.
- When sitting for long periods, occasionally elevate your legs by placing your feet on a footstool. If possible, get up and move around every half-hour or so.
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