Chiropractor readjusting the cervical of a patient lying on a stretcher in a clinic
For individuals affected by headaches that occur 15 or more days a month for more than three months, can knowing the signs and symptoms help healthcare providers help treat and prevent chronic tension headaches?
Table of Contents
Most individuals have experienced a tension-type headache. The pain is usually described as a dull tightening or pressure on both sides of the head, like having a tightening band around the head. Some individuals experience these headaches frequently, a condition known as chronic tension headaches. Chronic tension headaches are uncommon but can be debilitating, as they can interfere with a healthy quality of life and daily living.
Individuals experiencing headaches that interfere with daily life or need to take medication more than twice a week are recommended to consult a healthcare provider. Before the appointment, it can be helpful to keep a headache diary:
Some questions the healthcare provider may ask include:
A healthcare provider will likely be able to diagnose the condition based on symptoms alone. However, if the headache pattern is unique or different, the provider may order imaging tests, like MRI or CT scans, to rule out other diagnoses. Chronic tension headaches can be confused with other chronic daily headache disorders like chronic migraine, hemicrania continua, temporomandibular joint dysfunction/TMJ, or cluster headaches. (Fayyaz Ahmed. 2012)
Pharmacological therapy for chronic tension headaches usually involves preventive medication.
Additional preventive medications may include other antidepressants like:
A healthcare provider may also prescribe medication to treat headache episodes, which include:
Behavioral therapies are sometimes used on their own or in combination with medication to prevent and manage chronic tension headaches. Examples include:
Some individuals with chronic tension headaches may find relief using supplements. The American Academy of Neurology and the American Headache Society report the following supplements can be effective: (National Center for Complementary and Integrative Health. 2021)
If the headaches come on suddenly, cause waking up from sleep, or last for days, itβs important to consult a healthcare provider to rule out any underlying causes and develop a personalized treatment plan.
Cleveland Clinic. (2023). Tension Headaches.
Ahmed F. (2012). Headache disorders: differentiating and managing the common subtypes. British journal of pain, 6(3), 124β132. doi.org/10.1177/2049463712459691
Jackson, J. L., Mancuso, J. M., Nickoloff, S., Bernstein, R., & Kay, C. (2017). Tricyclic and Tetracyclic Antidepressants for the Prevention of Frequent Episodic or Chronic Tension-Type Headache in Adults: A Systematic Review and Meta-Analysis. Journal of general internal medicine, 32(12), 1351β1358. doi.org/10.1007/s11606-017-4121-z
Mullally, W. J., Hall, K., & Goldstein, R. (2009). Efficacy of biofeedback in the treatment of migraine and tension type headaches. Pain physician, 12(6), 1005β1011.
Probyn, K., Bowers, H., Mistry, D., Caldwell, F., Underwood, M., Patel, S., Sandhu, H. K., Matharu, M., Pincus, T., & CHESS team. (2017). Non-pharmacological self-management for people living with migraine or tension-type headache: a systematic review including analysis of intervention components. BMJ open, 7(8), e016670. doi.org/10.1136/bmjopen-2017-016670
National Center for Complementary and Integrative Health. (2021). Headaches: What You Need To Know.
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