bizMe

I feel so stressed and have such an annoying headache today!!!!

What is a tension type headache?
Tension-type headache, also known as stress headache or muscle-contraction headache, is one of the most common headaches occurring in the general population particularly in people between the ages of 20 and 50 and most commonly in women.

Do we know what the cause is?
The cause is not clear; however, tension headaches seem to be related to a number of factors including stress, anxiety, as well as muscle tensions. Also the majority of people who get migraines also get tension-type headache pain.

What are factors that might trigger a tension headache?
There are many possible triggers of tension headaches. Potential triggers include: stress, mental disorders such as depression and anxiety, skipping meals, lack of sleep, poor posture or long hours working in awkward positions, and lack of exercise.

What does the tension headache feel like?
Tension-type headache is often described as a headache that feels like a tight cap, or a band around the head, or a heavy weight on the head or shoulders coupled with a pain of mild or moderate intensity. The type of pain is usually steady, non-pulsating, and often located on both sides of the head or shoulders.

Usually tension headache is not associated with nausea, vomiting, visual disturbances, persistent or very severe pain, fever, confusion, worsening of headache with changes in body position, tingling, numbness or decreased strength in one side of the body. If any of the aforementioned symptoms are present consult immediately with your doctor.

How often does it occur?
Most patients with tension headaches have a various number of attacks which may range from as many as seven times per month to as few as less than one day a month.

How can tension headache be treated?
Tension headache can be often treated acutely with over-the-counter (OTC) medications; thus, few people usually tend to seek medical advice for tension headaches.

Medications: there is a variety of over-the-counter (OTC) and prescription drugs that are available for treating tension headache. Pain relievers such as aspirin, ibuprofen (Advil, Motrin, others) or acetaminophen (Tylenol, others) may be effective in relieving the headache. No doctor prescription is needed for these medications. Whether the headaches are episodic or chronic try to take the medications only when necessary, and use the smallest dose needed to relieve your pain and avoid overuse which can paradoxically cause rebound headaches. Remember that OTC medications also have side effects: ibuprofen (Advil, Motrin IB, and others) and naproxen sodium (Aleve) can cause, nausea, stomach bleeding, and ulcers. You can limit these side effects by taking the medication after meals. Acetaminophen (Tylenol, and others) in high doses and or in combination with other medications can cause liver toxicity.

If I don’t want to take medications, are there any other forms of treatment?
Yes. Tension headaches can also be treated with non-pharmacologic preventive interventions. Such interventions include mainly what we would call cognitive-behavioral treatments. However, there is no solid scientific evidence proving the effectiveness of these treatments.

Behavioral treatments for headache, can be helpful, and include: cognitive-behavioral therapy (i.e. stress management), relaxation, and biofeedback.

Cognitive-behavioral therapy has the purpose of identifying and teaching patients to better respond to distorted thinking and belief patterns, and then developing new and healthy ways of behaving.

Relaxation
Relaxation techniques can also be helpful in the reduction of stress and worry, which may trigger and be a cause of a tension headache. There are different forms of relaxation which may include muscle relaxation, meditation, passive relaxation, or self-hypnosis, none of which will be discussed here.

Biofeedback
Biofeedback is a technique by which patients may be able to control some of their unconscious processes when information about such processes is relayed back to the brain in the form of a visual or auditory signal. Is that right?
However, it is important to keep in mind that the effectiveness of behavioral therapies has not been evaluated in recent research or rigorous clinical trials.

Who should undergo preventive treatment?
Not everyone. It is important to remember that preventive treatment might be appropriate for patients who have multiple episodes of tension headaches (10 or more per month). On the other hand, for patients with infrequent headaches, (less than 1 day per month) preventive treatment is not needed.

Are there any prescription medications that can help in the prevention of tension headaches?
Yes. Certain medications taken at regular intervals may reduce the frequency and severity of attacks. Tricyclic antidepressants, including amitriptyline (Elavil), are the most commonly used medications to prevent tension headache. SSRI (for example, Zoloft or Paxil), a different class of antidepressant medications, can also be used. However, for any use of such medications check with your doctor before beginning any prescription therapy.

Besides medications, is there any other remedy that may help prevent the occurrence of tension headaches?
Yes. Although it is true that medication can be effective to temporarily relieve tension headaches, lifestyle modifications are one of the best ways to fight tension headaches. A few simple strategies may help:

Exercise regularly. Regular aerobic exercise such as walking, swimming or biking, can help reduce the frequency and intensity of headaches. Exercise can relive stress which in certain cases may be a key trigger. However, check with your doctor before beginning any exercise program. Stretching and learning to assume correct posture also can help prevent tension headaches.

Posture: Good posture supports and protects all parts of your body and allows you to move efficiently. Thus, regular stretching and strengthening exercises for your neck and shoulders is important. Wearing poorly fitting shoes or high heels also can cause posture problems. Avoid staying in the same position for long periods of time—if you can, take a break and walk around. When you are sitting avoid having your head slumped forward.

Doctor D, MD

Dear Reader:
The above article is not to replace in any way the need to see your physician at any time you deem appropriate. The purpose of this brief article is only that of providing some knowledge about a specific yet common medical topic. The underlying principle is that knowledge is power to foster growth, development, and lifelong learning.