The diagnosis of tension-type headache is mainly based on the criteria at the end of this article and the symptom description above. In addition, you need to see a clinician (doctor, neurologist, physiotherapist, chiropractor or other headache specialist) who can rule out other causes, perform a neurological examination, assess movement in the neck, back, shoulders and jaw, and feel the muscles and tenderness in the neck, jaw, face, skull and shoulders.

You are welcome to start with a digital consultation and/or a physical consultation by booking here.

There are three likely causes of tension headaches:

• Muscle tension in the head, neck or shoulder muscles, or changes in blood flow to the brain (less important compared to migraine)
• Hereditary factors
• Increased sensitivity to pain signals over time, centrally in the brain (central sensitization). The chronic headache of tension headache usually develops from the frequent tension headache through a central sensitization process.

The following can be factors that increase the risk of getting a tension headache:

• Inability to relax after work
• Few hours of sleep
• Coexisting migraine
• Overuse of acute headache medicines
• Depression

The most common precipitating factors/triggers are:

• Poor sleep routines
• stress
• High physical exertion
• Overuse of medication can be a factor.

Remember that what you think is a trigger is not a trigger every time. Read more about this here.

Exposure to the above triggers can further aggravate the headache. As a general rule, physical activity does not exacerbate tension headaches when you have an attack, but can do so if the pain is intense.

When you have a seizure, the following can work:

• Neck and shoulder stretching or massage
• Relaxation
• Sleeping
• Physical activity (mild to moderate level)
• Apply peppermint oil to your temples

Prevention of tension headaches should include:

• Managing stress
• Optimizing sleep
• Improving lifestyle, especially sleep, ability to relax and good physical activity routines
• Avoid known triggers, or gradually expose yourself to triggers under controlled conditions.

If you have an increasing number of headache days, more than 2 days per month, you need to take your headaches seriously and seek help to reduce the risk of them becoming chronic. (Link to booking page)

Also remember to seek help if your pain changes, becomes more painful, and if you experience other changes such as weight loss, new neurological signs or symptoms, or changes in memory or personality. Read more here about red flags and secondary headaches.