Tension-type Headaches - A Summary

Relaxation. Different people find different things helpful. A walk, some exercise, or simply taking a break from the normal routine may help. A massage of your shoulders and neck muscles may be helpful. A hot flannel put on your neck or a warm bath may help.

Paracetamol often works well. It is best to take a full dose as soon as a headache starts. This may 'ward off' the headache better than treating it after it has fully developed. You can take a second dose after four hours if necessary.

Anti-inflammatory painkillers are alternatives. For example, ibuprofen which you can buy; however, you need a prescription for other types. On average, anti-inflammatory painkillers probably ease the pain in more people with headaches than paracetamol does. However, some people develop side-effects such as stomach problems. So, it is probably best to see how you get on with paracetamol first before trying an anti-inflammatory painkiller. Read the leaflet which comes with the medicine packet for a list of possible side-effects and cautions.

Aspirin at full dose, is probably the most effective drug for easing a tension-like headache. However, some doctors do not recommend aspirin, as it has an even higher risk of causing stomach side-effects than anti-inflammatory painkillers have. Bearing this in mind, you may wish to try aspirin if you do not tend to get much relief from paracetamol or anti-inflammatory painkillers. Read the leaflet which comes with the medicine packet for a list of possible side-effects and cautions. Children under the age of 16 should not take aspirin.

Diary. It is useful to keep a diary if you have frequent headaches. Note when, where, how bad, and how long each headache lasts. Also note anything that may have caused it. A pattern may emerge and you may find a 'trigger'. For example, hunger, anxiety, bad neck posture, eye strain, stress. You may be able to avoid situations that trigger your headaches.

Bad posture, particularly sitting at a desk for long periods, may cause tension on the neck muscles and lead to a headache. Is this a possibility? Can it be corrected?

Poor eyesight can make you squint when you read and cause tension of the muscles around the eye. This may lead to headaches. An eye test may be a good idea.

Stress is a common trigger for headaches. Learning to cope with stress and to relax may help. Breathing or relaxation exercises may ease anxiety in stressful situations, and prevent possible headaches. There are plenty of books and tapes which can teach you how to relax.

Regular exercise. On average, tension-type headaches are more common in people who do not take much exercise compared to those who do. If you do not do much exercise, it may be worth trying regular exercise like brisk walking, jogging, cycling, swimming, etc. It is not clear how exercise helps. It may be that exercise helps to ease stress and tension, which can have a knock-on effect of reducing headaches.

See a doctor:

• if you take painkillers more than two days a week for headaches. Sometimes painkillers are the cause of headaches if you take them too often. This is because, if the body becomes too used to painkillers, a 'withdrawal' headache may occur if you do not take painkillers regularly.
• if you have frequent headaches. A medicine may be advised to prevent headaches.
• if you think your headaches are not the common 'tension-type' headache.