Introduction

Tension-type headache (TTH) is the most common form of primary headache disorder, affecting people of all ages worldwide. It is typically described as a bilateral, pressing, or tightening pain of mild to moderate intensity, often referred to as a “band-like” sensation around the head. Unlike migraine, TTH is not usually associated with nausea, vomiting, or significant sensitivity to light and sound, though mild photophobia or phonophobia may occur.

🔎 Symptoms

• Pain quality: Dull, aching, and pressing/tightening (not throbbing).
• Location: Typically felt on both sides of the head (bilateral), often described as a “band” or “tight cap” sensation.
• Intensity: Mild to moderate (not disabling).
• Associated features:
  • Scalp, neck, or shoulder muscle tenderness
  • No nausea or vomiting (unlike migraines)
  • May have light or sound sensitivity, but never both at the same time
• Duration:
  • Episodic: 30 minutes to several hours, but less than 15 days/month
  • Chronic: Occurs ≥15 days/month for at least 3 months

⚠️ Causes & Triggers

The exact cause isn’t fully understood, but contributing factors include:

• Muscle tension in scalp, neck, or shoulders
• Stress and anxiety
• Poor posture (desk work, long screen time)
• Eye strain
• Sleep disturbances
• Skipping meals or dehydration
• Overuse of painkillers, leading to medication-overuse headaches

💊 Treatment

1. Acute (relieving an episode)

• OTC pain relievers: Acetaminophen (paracetamol), ibuprofen, naproxen, or aspirin
• Non-drug measures: Rest, stretching, applying heat to neck/shoulders, relaxation techniques

2. Chronic or Frequent TTH

• Preventive medications (if very frequent/chronic):
  • Tricyclic antidepressants (e.g., amitriptyline)
  • Sometimes muscle relaxants or other antidepressants
• Non-drug therapies:
  • Cognitive-behavioral therapy (CBT)
  • Biofeedback
  • Physical therapy
  • Massage, acupuncture, or relaxation training

⚠️ Important: Avoid overusing painkillers, as this can worsen headaches.

✅ Prevention

• Stress management: Meditation, yoga, breathing exercises
• Regular exercise: Aerobic activity, stretching
• Ergonomics: Proper workstation setup, avoid slouching
• Sleep hygiene: Consistent sleep schedule, quality sleep
• Limit screen time: Take breaks to rest eyes and stretch
• Hydration & diet: Drink water, avoid skipping meals
• Keep a headache diary: Track triggers, frequency, and response to treatment