Tension Headaches: Causes, Relief and When to Worry
By Dr Charbel Alam, Osteopath & Physiotherapist · 5 min read
What a tension headache feels like
People often describe a band of pressure around the head, a dull ache on both sides or tightness in the neck and shoulders. Unlike a typical migraine, it does not usually get worse with routine activity or cause vomiting.
Common triggers
Headaches rarely have one single cause. Common contributors include:
- Stress and poor sleep
- Long periods at a desk or looking down at a phone
- Tight or tender neck and upper-shoulder muscles
- Skipped meals, dehydration and eye strain
How treatment can help
An assessment looks at your neck movement, muscle tension and daily routine. Treatment may combine hands-on work for the neck and upper back with strength and posture exercises you can continue at home.
Treatment also looks at your routine: regular breaks, a better screen setup, sleep and stress. Keeping a simple headache diary can help you and your clinician spot patterns.
Red flags: when to seek urgent medical care
Go to an emergency department or see a doctor immediately if a headache:
- Comes on suddenly and severely, like the worst headache of your life
- Comes with weakness, numbness, confusion, vision loss or difficulty speaking
- Comes with fever, a stiff neck or a rash
- Follows a head injury
- Is new or changing, especially after age 50, or wakes you from sleep and keeps worsening
Related services
Questions patients ask
Can neck problems cause headaches?
Yes. Tension in the neck and upper shoulders is linked to tension-type headaches, and some headaches come directly from structures in the neck.
Can osteopathy or physiotherapy help tension headaches?
They can help some people, especially when neck tension or desk habits are part of the problem. An assessment also checks whether you should see a doctor first.
How often is too often to take painkillers for headaches?
Using painkillers very frequently can itself make headaches more common. If you need them on many days each month, speak to your doctor.
This article is general information and does not replace an individual assessment. If you have severe, worsening or unusual symptoms, seek medical advice.