Tension Headache: Symptoms, Causes, Healing Cycle & Treatment

What is a Tension Headache?

Tension headaches are one of the most common types of headaches that so many people suffer from. They are often described as the feeling of a  tightening band around the head, with dull aching pain that is usually mild to moderate in intensity. Other symptoms commonly associated with tension headaches include tightening of the neck and back muscles, tiredness, irritability, and difficulty focusing on everyday tasks. It is also called a stress headache and tends to occur repeatedly. Depending on the frequency of the occurrence of these headaches, they may be classified as episodic or chronic. (1)  

What Causes Tension Headache?

Tension headaches may be caused by several different factors. The common causes of tension headaches are the following: 

  1. Poor posture: One of the most common causes of tension headaches is poor posture. Poor posture, such as slouching forwards causes the fascia at the nape of the neck to stretch excessively. This injury due to stretching results in the formation of scar tissue that develops tension in your neck and extends to the forehead.
  2. Stress: It has been hypothesized that psychological stress and lack of sleep cause an autonomic disturbance that increases the sympathetic drive. Not only can this precipitate a tension headache, but it may also worsen it. (2)
  3. Alcohol: Intake of alcohol can result in a more frequent occurrence of tension-type headaches. This is particularly prevalent in those with disorders related to excessive alcohol intake. (3)
  4. Infection: Common infections such as catching a cold or flu can trigger tension headaches, which may be due to the dress on the body’s immune system.
  5. Caffeine: If you drink too much coffee, or skip the usual amount of caffeine in your routine, this divergence can cause a tension headache.
  6. Eye strain: Impaired vision or focusing the eyes for a prolonged period, such as staring at a computer or LED screen for long hours, or focusing on detailed work causes strain in the eye muscles and leads to the development of a tension-type headache. (4)
  7. Dental problems: Toothache, infections, or other dental issues that may cause clenching of the jaw or grinding the teeth can result in strain on the temporomandibular joint which precipitates tension headache.
  8. Smoking: Cigarette smoke causes vasoconstriction which may compromise the blood supply to the brain and trigger a headache.
  9. Fatigue: Excessive fatigue and lack of rest trigger the sympathetic nervous systems and results in the development of tension-type headaches.

How Do Tension Headaches Occur?

To understand the pathophysiology of tension headaches, we need to understand the normal healing process that occurs in our body. 

In response to an injury, the immune cells release inflammatory mediators that cause pain and tenderness. This is followed by repair of the area through proliferation and eventually, the formation of scar tissue or fibrosis. The growth of scar tissue is normally limited by our body through remodeling. However, if the causative factor of the injury persists, the scar tissue continues to grow without any limiting factors. (5)

Excessive stretch on the muscles of the neck and head causes the fascia to develop micro-injuries. In an attempt to heal this injury, our body starts to produce scar tissue. The problem arises when the development of scar tissue is excessive to the body’s requirement. This extra amount of scar tissue puts pressure on and compresses the blood vessels carrying blood to our brain. Reduced blood flow to the brain compromises its functionality and causes pain in the frontal and temporal regions bilaterally. This is known as a tension headache. 

How to Treat Tension Headaches?

The use of heating pads and ice may bring temporary relief but cannot treat the headache. The same goes for common practices like massage, the use of foam rollers, etc. By putting pressure on the side of injury, they cause worsening of the inflammatory process. 

To effectively treat tension headaches, we need to determine which stage of the healing process is going on. Depending on the stages, the following treatments can be applied:

Tension Headache Healing Cycle

Inflammatory Stage:

  1. MagnaHeal: MagnaHeal is available in a band form that can be worn easily almost anywhere on the body. The depth of its magnetic field is about 3 inches. This helps in limiting mild to moderate inflammation.
  2. Anti-inflammatory diet: If the level of inflammation is more severe, it is necessary to put the patient on an anti-inflammatory diet. This includes cutting down on alcohol, caffeine, and refined carbohydrates.
  3. Supplemental Nutrition: The deficiency of essential vitamins, nutrients, and minerals prevents healing by keeping your body in a constant state of chronic inflammation. You can use askASTR, a free online database combining the expertise of at least 9 experts, and answer a few questions to find out what nutrients are deficient in your diet.

Proliferation Stage: 

 Scar tissue, trigger point, and fascia release: The A3 and A5 tools help to release superficial and deeply formed scar tissue, respectively. These help to break the excessive scar tissue. For long-term relief from tension headaches, it is essential to target the adhesions formed in the superficial and deep layers of the fascia that covers our muscles. This allows for improved mobility without putting strain on the muscles and other deeper structures. For this purpose, the A1 and A5 tools are used to target the superficial and deep fascia respectively. 

To prevent the future occurrence of tension headaches, the triggering factors and causes need to be focused on and eliminated. Some practices that may help in this regard are: 

  1. Correction of posture.
  2. Decrease excessive eye strain by limiting screen time and taking breaks in between tasks.
  3. Avoid smoking and alcohol intake.
  4. Do not grind teeth or clench the jaw. Refer to the dentist for timely management of dental problems. 

To correctly and effectively treat tension-type headaches, we need to focus on all the causative elements and target specific pathophysiological problems. Hope this helps!


1. Shah N, Hameed S. Muscle Contraction Tension Headache. In: StatPearls [Internet]. StatPearls Publishing; 2021.

2. Cathcart S, Winefield AH, Lushington K, Rolan P. Stress and tension-type headache mechanisms. Cephalalgia [Internet]. 2010 Oct [cited 2021 Sep 16];30(10). Available from: https://pubmed.ncbi.nlm.nih.gov/20873360/

3. Domingues RB, Domingues SA, Lacerda CB, Machado TV, Duarte H, Teixeira AL. Alcohol use problems in migraine and tension-type headache. Arq Neuropsiquiatr [Internet]. 2014 Jan [cited 2021 Sep 16];72(1). Available from: https://pubmed.ncbi.nlm.nih.gov/24637978/

4. Tension headache [Internet]. [cited 2021 Sep 16]. Available from: https://medlineplus.gov/ency/article/000797.htm

5. Gilmore MA. Phases of wound healing. Dimens Oncol Nurs [Internet]. 1991 [cited 2021 Sep 16];5(3). Available from: https://pubmed.ncbi.nlm.nih.gov/1823567/

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