Health A-Z

Medical Content Created by the Faculty of the Harvard Medical School


What Is It?

Tension headaches are the most common type of headache. These headaches are not caused by disease. They are often considered to be "normal" headaches. Other names for tension headaches are ordinary headaches, muscle tension headaches, and stress headaches.

The International Headache Society has suggested that doctors use the term tension-type headaches because so many different names have been used for tension headaches. Typically tension-type headache causes mild to moderate pain, usually on both sides of the head. There is a pressing or tightening sensation. It is not pulsating and is not accompanied by nausea. The headache does not get worse with routine physical activity.

The society has defined different categories based upon how frequently tension-type headaches occur and how persistent they are:

  • Infrequent episodes of tension-type headache

    • Less than 12 episodes per year

    • Each episode may last from 30 minutes to 7 days

  • Frequent episodes of tension-type headache

    • Between 1 and 14 episodes per month on average

    • Each episode may last from 30 minutes to 7 days

  • Chronic (persistent) tension-type headache

    • At least 15 episodes per month on average

    • The headache lasts for hours and it may be continuous

    • Mild nausea may occur some of the time

The exact cause of tension headaches is unknown. But there appear to be several contributing factors.

In part, they result from changes in how the nerves of the head, neck and shoulders sense pain. They are also caused by changes in the brain's interpretation of the pain signals sent from the muscles in the head and neck. Emotional stress and muscular tension also probably act as triggers.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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