Article by John Miller
What is a Tension Headache?
A tension headache is the most common form of a primary headache. It happens intermittently in up to 80% of the population. As the symptoms are not as severe as a migraine, Tension Headache is only considered a problem if it becomes frequent or chronic.
What are the Symptoms of a Tension Headache?
Frequent Tension Headache is recognised when the sufferer has experienced at least 10 headaches in a one month period. There are varying degrees of frequency and chronicity.
Chronic Tension Headache sufferers report headaches on more than 180 days in a year. Tension Headache pain tends to be bilateral, and pressing or tightening in nature. It is of mild to moderate intensity and will not tend to interrupt work.
Tension Headache sufferers can experience symptoms associated with migraine such as nausea and photophobia (hypersensitive to light) or phonophobia (hypersensitive to sound), but usually only one of these symptoms.
How is a Tension Headache Diagnosed?
There is no one specific test that identifies tension-type headache. Your diagnosis will be made based on your health professional's interpretation of your symptoms and how you respond to different treatments
What about X-rays, CT-scans and MRI?
Unfortunately X-rays, CT-scans and MRI's are not diagnostic of a tension headache. You can suffer a tension type headache with or without some abnormal findings on X-rays or scans. Likewise, scan abnormalities do not guarantee that you will experience a tension headache.
However, X-rays and scans may identify structures that could potentially be causing your tension type headache. We recommend that you have at least cervical spine X-rays if you have been suffering headaches or head pain for any extended period.
How Can Physiotherapy or Massage Help You?
Quality neck physiotherapy or massage can have a very quick and effective result for relieving your tension headache through relaxation of muscles under excessive tension. It is also important to remember that excessive muscle tension will compress, distort or irritate joint structures that cause neck headache, which will further complicate your symptoms.
Your tension-type headache treatment may include all or some of the following techniques:
What if Physiotherapy or Massage Can't Help You?
Since there are over 300 sources of a headache, and tension-type headache is responsible for some.
You may also be suffering from a mixed or a multi-source headache. In these instances, your neck headache may be solved but another source of your head pain could linger.
Your physiotherapist will advise you if you have symptoms that could indicate a different cause for your headache. In these instances, they will also direct you towards further investigations or tests that may assist your diagnosis and subsequent treatment.
Mixed Headache-Migraine Types
You can simultaneously suffer one, two or more types of a headache or a migraine.
One type may cause another or overlap with another. For example, a painful neck can cause an increase in muscular tension, which will increase your blood pressure. In this scenario, you would be suffering a neck headache + tension headache + migraine!
In our experience, finding the primary source of your headache or a migraine is the key to successful management.
What Else Could Be Causing Your Headaches or Migraine?
Your physiotherapist and doctor will be able to assist your diagnosis and headache source. Sometimes specific tests can confirm your diagnosis. On other occasions, it can be a process of elimination.
In a small percentage of patients, there is, unfortunately, a sinister cause of your head pain, which should be thoroughly investigated. These can include brain tumours, aneurysm, meningitis and other systemic illnesses.
Your physiotherapist or doctor may recommend that you complete a headache or migraine questionnaire that will assist in your headache classification, diagnosis and treatment. Once you complete these questionnaires please present the results to your physiotherapist or doctor to assist your diagnosis and treatment.
At PhysioWorks, we have a special interest in the assessment, diagnosis and treatment of a neck headache, tension-type headache, stress headache and jaw headache.
For more information, please ask your physiotherapist.
Headache RED FLAGS!
If suffer any of the following symptoms, please notify your physiotherapist or doctor as soon as possible.
All Red Flags MUST be thoroughly investigated!
We urge you to check with your doctor or physiotherapist to investigate further if your headaches have any of the following characteristics:
If you have any of the above Red Flags symptoms, we strongly recommend that you inform your physiotherapist and seek the advice of your doctor or an emergency department immediately.
Can an Unsupportive Pillow Cause Tension Type Headaches?
Yes. Unfortunately, a non-supportive pillow or one not suited to your neck can predispose you to neck pain or tension type headache.
If you suffer neck pain or headache, it is wise to ask for the professional advice of your physiotherapist regarding what pillow style and size they would recommend for you.
Pillows do vary and the best one for your neck shape and body size will help you prevent neck pain and neck headache.
More info: Best Pillows
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