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Causes

By Mayo Clinic staff

The exact cause or causes of tension headache are unknown. Experts used to think that the pain of tension headache stemmed from muscle contraction in the face, neck and scalp, perhaps as a result of heightened emotions, tension or stress. But research suggests that there doesn't appear to be a significant increase in muscle tension in people diagnosed with tension headache.

The most common theories support interference or "mixed signals" involving nerve pathways to the brain, which is demonstrated by a heightened sensitivity to pain in people who have tension headaches. Increased muscle tenderness, a common symptom of tension headache, may be the result of overactive pain receptors.

Triggers
It's likely other factors also contribute to the development of tension headaches. Potential triggers may include:

  • Stress
  • Depression and anxiety
  • Poor posture
  • Working in awkward positions or holding one position for a long time
  • Jaw clenching
Risk factors Symptoms
References
  1. Tension-type headache. National Headache Foundation. http://www.headaches.org/education/Headache_Topic_Sheets/Tension-Type_Headache. Accessed Nov. 24, 2010.
  2. Ropper AH, et al. Headache and other craniofacial pains. In: Ropper AH, et al. Adam's and Victor's Principles of Neurology. 9th ed. New York, N.Y.: The McGraw-Hill Companies. 2009. http://www.accessmedicine.com/content.aspx?aID=3631051&searchStr=cluster+headache. Accessed Nov. 24, 2010.
  3. Crystal SC, et al. Epidemiology of tension-type headache. Current Pain and Headache Report. 2010;14:449.
  4. Headache: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/headache/detail_headache.htm. Accessed Nov. 29, 2010.
  5. Monteith TS. Tension type headache in adolescence and childhood: Where are we now? Current Pain and Headache Report. 2010;14:424.
  6. Taylor FR. Tension-type headache in adults: Pathophysiology, clinical features and diagnosis. http://www.uptodate.com/home/index.html. Accessed Nov. 24, 2010.
  7. Lenaerts ME. Epidemiology of tension-type headache (TTH). Expert Opinion on Pharmacotherapy. 2009;10:1261.
  8. Headache diary. National Headache Foundation. http://www.headaches.org/pdf/Headache_Diary.pdf. Accessed Nov. 30, 2010.
  9. Taylor FR. Tension-type headache in adults: Acute treatment. http://www.uptodate.com/home/index.html. Accessed Nov. 24, 2010.
  10. Taylor FR. Tension-type headache in adults: Preventive treatment. http://www.uptodate.com/home/index.html. Accessed Nov. 24, 2010.
  11. Holroyd AH, et al. Tricyclic antidepressants for migraine and tension-type headaches. British Medical Journal. 2010;341:841.
  12. Linde K, et al. Acupuncture for tension-type headache. Cochrane Database of Systematic Reviews. 2009:CD007587.
DS00304 Feb. 8, 2011

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