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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Tension Headache

Tension Headache

Tension Headache is a chronic type of headache which may be as a result of stress or fatigue. Generally tension headache is due to physical problems, psychological issues, or depression. Both men and women are affected, but women are more commonly affected. Generally disease onsets between the age of 20 and 40, and any person can be affected.


Generally these headaches may be the result of stress or fatigue, but more than likely, the other causes can be physical problems, psychological issues, or depression.  The headache generally occurs every day, and may have been going on for months, is chronic in case of tension headache. It is the frequency that distinguishes episodic from chronic headaches.


  • Muscles may contract in between head and neck for hours or days
  • Patient may be left with stiff neck
  • There may be soreness or tightness around head
  • pain is continuous, annoying, and sometimes throbbing
  • Headache primarily includes forehead, temples or back portions of head and neck
  • Changes in sleep patterns
  • Headache may have early morning/late day occurrence
  • Shortness of breath
  • Constipation
  • Nausea
  • Weight loss
  • Fatigue
  • Palpitations
  • Dizziness
  • Menstrual problems
  • Feelings of guilt
  • Hopelessness
  • Unworthiness
  • Fear of mental or physical disease or death
  • Concentration problems and poor memory  

Precipitating Factors

Various precipitating factors which may lead to the tension headache include –

  • Poor posture and poor lighting conditions while working,
  • Arthritis, particularly cervical arthritis may lead to tension headache
  • Abnormal neck muscles, bones and intervertebral discs
  • Stress on Eye may precipitate
  • Abnormal alignment of teeth or jaws
  • Noise or lighting


The drugs commonly used for the treatment of tension headaches include -

  • NSAIDs or Nonsteroidal Anti-inflammatory Drugs like Fenoprofen, Flurbiprofen, Ketoprofen, Naproxen, Nabumetone, and Oxaprozine are routinely prescribed to the patients
  • Antidepressants especially Tricyclic antidepressants which don’t cause any sedation like Protriptyline, Desipramine can be prescribed to some patients
  • Antidepressants especially Tricyclics antidepressants which are sedatives like Amitryptyline, Doxepin, Nortriptyline.Imipramine can also be prescribed to some of the patients depending on case to case basis
  • Selective Serotonin Reuptake Inhibitors (SSRI) like Fluoxetine, Sertraline, Paroxetine, Nefazodone, Venlafazine, Citalopram, Escitalopram are also prescribed to some patients.