Symptoms

Signs and symptoms of a tension-type headache include:

• Dull, aching head pain
• Sensation of tightness or pressure across the forehead or on the sides and back of the head
• Tenderness in the scalp, neck and shoulder muscles

Tension-type headaches are divided into two main categories — episodic and chronic.

Episodic tension-type headaches

Episodic tension-type headaches can last from 30 minutes to a week. Frequent episodic tension-type headaches occur less than 15 days a month for at least three months. Frequent episodic tension-type headaches may become chronic.

Chronic tension-type headaches

This type of tension-type headache lasts hours and may be continuous. If your headaches occur 15 or more days a month for at least three months, they're considered chronic.

Tension-type headaches versus migraines

Tension-type headaches can be difficult to distinguish from migraines. Plus, if you have frequent episodic tension-type headaches, you can also have migraines.

Unlike some forms of migraine, tension-type headaches usually aren't associated with visual disturbances, nausea or vomiting. Although physical activity typically aggravates migraine pain, it doesn't make tension-type headache pain worse. An increased sensitivity to either light or sound can occur with a tension-type headache, but this symptom isn't common.

When to see a doctor

Make an appointment with your doctor

If tension-type headaches disrupt your life or you need to take medication for your headaches more than twice a week, see your doctor.

Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different. Occasionally, headaches may indicate a serious medical condition, such as a brain tumor or rupture of a weakened blood vessel (aneurysm).

When to seek emergency help

If you have any of these signs or symptoms, seek emergency care:

• Abrupt, severe headache
• Headache with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties
• Headache after a head injury, especially if the headache gets worse