Headaches are very common and estimated to be the ninth most common reason to visit the doctor. Tension-type headaches are the most common and occur in a third to three-quarters of people over their life. Cervicogenic headaches arise from the upper neck joints and can be treated in the same way as other spinal joint disorders.

What Causes Tension Headache?

The cause of this type of headache is not clear but is believed to be related to both psychological and muscular tension aspects. Stress symptoms may result in poor posture and cause sustained, low-level contraction of the scalp and neck muscles, although there is no good evidence that muscles are responsible for this type of pain.

While muscle contraction has not been directly shown to be the source of pain, studies have shown that sufferers may have weaker neck extension muscles, the muscles that keep the neck up in normal posture.

Medical conditions can cause headaches, such as sinus infection, migraine and other conditions so constant headaches or frequent headaches should always be reviewed by a medical practitioner.

Man With Headache

Who Gets Tension Headache?

They are very common throughout the population, are thought to start off in the teenage years and occur in women 50% more often than in men.

Tension Headache Symptoms

  • Tight or pressure pain
  • In the forehead or at the back of the head
  • Both sided
  • Mild to moderate in severity
  • Not worse with physical activity

Tension Headache Treatment

The causes of the stress symptoms must be identified and corrected if treatment for TTH is to have a useful effect. This can include counselling, cognitive behavioural therapy (CBT), regular exercising, good diet and a good sleep routine. Meditation has been shown to reduce stress and restore normal hormonal levels over time.

Physiotherapy can help with musculoskeletal headache by teaching relaxation, performing mobilisation techniques, giving exercises, manual muscle stretching and trigger point treatments. Soft tissue massage and acupuncture have also been shown to have beneficial effects on headache. Patients should continue a programme of relaxation, cervical range of motion exercises, stretches and overall fitness training.


  1. Tension Headache – Medscape
  2. Headache – Tension Type. National Institute for Health and Clinical Excellence.

Last Review Date: 08-01-2020

Next Review Date: 07-01-2022