There probably aren’t many people who have not experienced tension headache at sometime or another. However some individuals suffer from them very frequently or even permanently.
They can be mild and irritating or as severe and debilitating as a migraine. Pain is often experienced in the front of the head, less commonly the back of the skull. They are often associated with neck stiffness. A frequently overlooked feature of tension headache is the presence of trigger points in areas of the neck and scalp. Pressure on these points will usually result in pain or discomfort in the distribution of the headache.
Tension headache usually occurs during the day and doesn’t normally cause loss of sleep which some other types of headache can do. It is often made worse by emotional tension or stress.
What Causes Tension Headache?
Nobody really knows but it’s thought to involve the soft tissues (muscles, tendons and ligaments) of the neck and scalp. Some authors, Mense and Simons for example, have suggested that trigger points may be the cause of the pain.
Trigger points are tender areas which arise in muscle from prolonged abnormal tension. This could be brought about by psychological and emotional stress or due to poor posture – sitting for long periods in front of a computer or by spending a lot of time reading.
Although trigger points seem to be the result of muscle tension, their presence is thought to increase the pain and extend it to other areas. For example, trigger points building up in some neck muscles are likely to cause pain in the side and front of the head.
Management of Tension Headache
- Drugs: these are the mainstay in conventional medicine. Aspirin, paracetamol (acetaminophen) and non-steroidal anti-inflammatory medications are those most commonly used. They are effective in some people but not others.
- Manipulation: osteopaths, chiropractors and physiotherapists will use massage and manipulation on the neck and upper back. The logic is that removal of tension in the neck muscles will stop the headaches. Often found to be fairly effective especially if given in combination with neck exercises.
- Acupuncture: many trigger points are in effect acupuncture points. Treatment with needles can disperse the trigger points and relax associated muscles.
- Trigger points: what’s been said above also applies to acupressure. Trigger points in the neck muscles, those at the base of the skull and over the temples are useful points to treat. The most common way of treatment is by firm finger pressure over the point. It may seem paradoxical that pressure on trigger points causes pain and is also used to treat the pain but trigger point therapy can be a very effective treatment for muscle pain. There are a number of good books on trigger points and acupressure for those who want to treat themselves.
- Breathing exercises: shallow breathing tends to increase muscle tension and people who are anxious tend to exhibit rapid and shallow breathing. Regular deep breathing exercises will help reverse this process and so prevent the build up of trigger points.
Headache is a symptom not an illness. The causes of headache are numerous and usually not serious but if you have severe or persistent headaches you should consult your doctor.
Resource
Muscle Pain by Mense and Simons. Pub. Lippincott Williams and Wilkins 2001
