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Tension headache relief

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 7 minutes read
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Tension headache is one of the most common types and feels like a tight band has been wrapped around your forehead, causing a constant ache in your temples. Your neck or shoulders might feel tight and sore and a dull ache or pressure can build up behind your eyes.

People call it a stress headache for good reason – it comes at the busiest or most stressful times. Other common triggers for tension headaches can be excessive noise or bright lights, certain smells, poor posture, eye strain, or dehydration. While frustrating, most people are able to continue with everyday activities.

Most people describe tension headaches as mild and short-lived. Many feel better after a sleep or a warm bath, and tension headaches usually respond well to simple painkillers like acetaminophen or ibuprofen. Let's talk you through how to beat a tension headache with both medicated and drug-free remedies.

Doctor’s advice

Treatments: home and drug-free

Once you understand the causes of your tension headaches, you can build up an armamentarium of methods and treatments to either stop them once they occur or prevent them from happening in the first place. If your tension headache is mild, you may prefer to stick to natural remedies and avoid medication. These natural remedies may also be used alongside medication to maximize benefits, with no added risk to you.

Hydration

Dehydration can cause or worsen a tension headache, so it’s important to maintain fluid levels, especially if exercising or in hot weather. If you think conditions are causing you to lose lots of fluid, it may help to use oral rehydration salts to replace the lost electrolytes, like sodium, which are lost in sweat.

Cold pack

A cold pack, such as a bag of frozen peas wrapped in a towel, can help relieve a headache if applied to the point of pain, such as the temple. Don’t exceed 20 minutes with this technique, so as not to interfere with circulation to the skin.

Warm compress

It’s trial and error, but some prefer a warm compress or heat pad vs a cold pack. This is especially effective during a tension headache if applied to the neck or back of the head. You can use a hot water bottle or a microwavable pack (only leave it on for 20 minutes at a time or you risk damaging the skin).

If you don’t have a compress on hand, you may find that an ointment that generates a feeling of heat, such as Tiger Balm, helps to alleviate pain when applied to the temples. Some of these ointments have distinctive smells which can be comforting.

Magnesium

Some studies have suggested magnesium supplements can help prevent or stop a tension headache in people who are deficient. More research is needed to see if it will work in people who are not deficient but given that standard supplements are relatively safe and well-tolerated it might be worth a try.

Exercise

Here at Healthwords we are big fans of activities that help mind and body perform at their best. With tension headaches, any exercise – walking, running, swimming, cycling – will help blood flow to the muscles and brain. Any exercise session – defined as getting out of breath and increasing your heart rate for at least 30 minutes – will release a wave of feel-good endorphins, which help to counteract stress. Core strengthening, weight training and conditioning can also help to improve posture and make the spine healthier, potentially releasing neck muscles and reducing tension build-up.

Stress

Stress is one of the biggest underlying factors in tension headaches, and it’s important to build in stress reduction techniques to your everyday routine. You will know what’s best for you, but some ideas include meditation or mindfulness, listening to music, dancing, or a good laugh with friends or family. Yoga or pilates help with stress and build exercise into your routine. These exercises build up and stretch the core muscles, including the paraspinal muscles, which are alongside the spine.

Sleep

Sleeping well is very important for regulating energy, emotions, and stress levels, as well as providing physical rest. Routine is key. Strive to maintain similar hours of bedtime and waking, regardless of weekday or weekend. If you need to catch up, your body much prefers an earlier bedtime to a sleep-in in the morning.

Mouth guard

It’s common for people to grind their teeth in their sleep, especially if restless or stressed, and your dentist may see signs of this. This can add to a tension headache and jaw or neck muscle tension. If you think this applies to you, you can buy a simple mouth guard to wear at night, or your dentist can tailor-make one for you, protecting your teeth, aiding sleep, and hopefully preventing headaches.

Caffeine

There’s evidence that caffeine – found in tea, coffee, cola, and caffeinated energy drinks – may help chase a tension headache away. Doctors even advise it after a certain procedure on the spine that can bring on headaches (a lumbar puncture). But, there’s a fine line – if you are a regular caffeine user, your body becomes reliant on it, and you can get a caffeine withdrawal headache if you cut out your daily dose.

Peppermint

Some find a peppermint tea can help to relax and unwind. Some research suggests that peppermint oil rubbed into neck muscles may also help them to relax and alleviate pain. Some enjoy the cooling sensation of menthol when rubbed into the temples, and it’s possible that the aroma of peppermint tea could have a similar effect.

Anti-glare computer screen and lighting

If you’re spending hours at your computer, the light of the screen and poor posture may be contributing to headaches. Address your workstation to make sure you’re at maximum comfort while maintaining a good and supported posture and try including some stretches in your daily routine. Consider adding an anti-glare device to the screen. Swap out any flickering fluorescent strip lighting and consider exchanging harsh white-blue spectrum lights with soft, warm white lights, which are more restful to the eye.

What medications should I use to relieve a tension headache?

You don’t usually need to see your doctor for the management of a tension headache. Instead, you can buy medications from your pharmacy. Acetaminophen or ibuprofen can be very effective either on their own or in combination. Codeine or other opioid painkillers are not usually recommended.

For the treatment of headaches, painkillers should only be used for a short period of time.

This is because taking painkillers over a long period (usually 10 days or more) may conversely lead to medication-overuse headaches developing. This happens when your body gets used to the painkiller and when you stop, the headache returns or gets worse.

How can I prevent tension headaches?

If you experience frequent tension-type headaches, you may want to keep a diary to try to identify what could be triggering them. You can then build in changes into your routine to avoid them.

Regular exercise and relaxation are important measures to help reduce stress and tension that may be causing headaches.

Maintaining good posture and ensuring you're well-rested and hydrated are always good ways to keep your body working well.

In some cases, your doctor may recommend acupuncture sessions over a 5-8 week period and sometimes with medications such as amitriptyline.

When should I see my doctor?

Most people experience headaches from time to time, and they are rarely a sign of something serious. However, there are certain symptoms and signs that can alert us to underlying causes that may need further evaluation and investigation. You should see a doctor urgently if you have any of the following:

  • a new headache that feels different in location or intensity to your usual headache, especially for those over 50 years of age

  • a new headache that came on suddenly and feels like the worse pain you have ever experienced

  • a headache with sudden loss of vision or you have persistent visual changes despite a recent eyesight test

  • a headache with any persistent weakness or numbness in your arms or legs or lack of balance

  • a headache with fever, vomiting, neck stiffness, drowsiness, or rash

  • a headache with a new seizure or collapse

  • a headache with any drowsiness or altered consciousness, especially if household members have the same

  • a headache with any change in thinking or behavior, or any change in personality

  • a headache following any type of head injury, even if days later (or up to 3 months), but persistent and worsening

  • a headache in your final trimester of pregnancy or up to 6 weeks after birth, especially with known high blood pressure or ankle swelling

  • a headache triggered by coughing, sneezing, bending or exertion

Other reasons to visit your doctor are if you're suffering headaches on a regular basis and they are having a significant impact on work, studies, or family life, if you are requiring pain relief for headaches at least 5 times a week, most weeks, if you experience visual symptoms such as aura for the first time, or you have a painful red and watery eye without diagnosis.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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