Just a Headache
Before I knew what to look for, I assumed that any mild head pain was a “tension headache” and more severe pain was “migraine”. I also assumed that the severity of the pain was what caused the associated symptoms of nausea and light sensitivity. I had no idea that mood swings, food cravings, the inability to think or communicate, and many other strange symptoms had anything to do with migraine at all. As I learned more about migraine, I was surprised to learn that I wasn’t getting tension-type headaches at all.
Not everyone is that lucky
We all know that there is so much more to migraine than the pain we feel in our heads. Yet sometimes, we can experience just a headache. These tension-type headaches can be mild and annoying or very painful. It’s not really the intensity of the pain that distinguishes migraine from tension-type headache.
Tension-type headache is the most common headache disorder, affecting 78% of the population. If you haven’t had a tension-type headache yet, chances are good that you will eventually experience one. While “just a headache” may not seem as bad as the symptoms of migraine, a tension-type headache can result in pain that ruins our day. Tension-type headaches can become chronic, affecting our everyday lives. Plus, frequent use of pain relievers to treat tension-type headaches can still put us at risk for Medication Overuse Headache. They can trigger a migraine attack, too. Finally, for those who have both Migraine and Tension-Type Headaches, it can be difficult to distinguish between the two.
The key distinguishing characteristics are:
- Pain is usually mild to moderate
- Pain feels like pressure or a vice, rather than throbbing
- Affects both sides of the head
- Movement does not make the pain worse
- No nausea or vomiting
- Light OR sound sensitivity, but not both
While the cause of tension-type headaches is not known, a neurobiological cause is strongly suspected. At one time, it was thought that tension-type headaches were caused by psychological disorders or emotional stress. Few practitioners believe that to be true anymore. However, there are several exacerbating factors and common triggers, such as:
- Poor sleep habits
- Poor posture
- Emotional or mental stress
Treatment depends largely on the frequency of attacks. The more frequently they occur, the more aggressive the treatment approach. In many cases of mild, infrequent tension-type headaches, a simple OTC analgesic works just fine. As with migraine, acute treatments should be used sparingly (not more than 2-3 times per week) to avoid the risk of Medication Overuse Headache. Plus, using aspirin, ibuprofen, or other NSAIDS too frequently can have serious gastrointestinal side effects. In more severe cases, muscle relaxers or prescription pain relievers may be prescribed. If the headaches occur 10 or more days each month, preventive treatments may be necessary.
Preventive treatment may include one or more strategies:
- Tricyclic antidepressants
- Muscle relaxants
- Physical therapy
- Massage therapy
- Cognitive behavioral therapy
- Stress management or relaxation training
In the case of high-frequency or daily tension-type headaches, it is important to rule out Medication Overuse Headache, New Daily Persistent Headache, or other primary or secondary headache disorders.
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