When Should I Call The Doctor
Most headaches arent dangerous. Rarely, headache pain can be a sign of a serious medical problem. You should seek immediate medical care if you have:
- Stiff neck.
- Sudden, severe headache that gets worse quickly.
- Fever that doesnt go away.
- Headache after concussion .
- Confused thoughts or slurred speech or weakness.
- New onset headache over the age of 50.
- Sudden change in your headache pattern.
- New onset headache in someone with cancer or autoimmune disease.
A note from Cleveland Clinic
Almost everyone experiences tension headaches. But that doesnt mean you need to live with the pain. Over-the-counter pain relievers may be enough to relieve minor symptoms. If you have a headache more days than not, reach out to your provider for guidance. Medication and stress management help many people reduce the impact of tension headaches on their life. Massage, meditation, exercise or talking to someone you trust are just some of your options. The best stress-management therapy is the one that works for your lifestyle and feels right to you.
Last reviewed by a Cleveland Clinic medical professional on 02/04/2021.
What Causes Headaches
Lots of different things can bring on headaches. Most headaches are related to:
- some medicines
- vision problems
- smelling strong odors such as perfume, smoke, fumes, or a new car or carpet
- some foods
For some teens, hormonal changes can also cause headaches. For example, some girls get headaches just before their periods or at other regular times during their monthly cycle.
What Is A Stress
During stressful situations, our bodies often go into fight or flight mode. Certain chemicals in the brain can be released during this time that can cause a variety of changes in the body that result in pain.
Stress-related headaches are also called tension headaches. When youre experiencing one, you may have a dull, achy pain along your forehead or through the back of your head. The pain sometimes starts in the neck or shoulders and progresses through areas around your head. Some people also experience aching or pain in the jaws and cheeks.
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What Is Chronic Tension Headache And Who Is Affected By It
Chronic tension headache is a condition where you have a tension headache on at least 15 days every month for at least three months.This can be tiring and depressing. Tension headache is the common type of headache that most people have at some time.
It’s not known exactly how common chronic tension headache is, as few studies have looked at this clearly. Some studies have estimated that around 1 in 30 of all adults have chronic tension headaches – which means they have a headache on more than half of all days for three months or more. However, it is possible that a proportion of these patients actually have developed medication-overuse headaches as a result of their tension headaches. Therefore, it can be difficult to be certain which is their main problem.
Chronic means persistent it does not mean severe. The severity of the headaches can vary from mild to severe. Because of the persistent nature of the headaches, however, this condition is often quite disabling and distressing, and most patients take preventative medication.
How Can I Prevent Tension Headaches
Researchers have yet to uncover how to prevent all headaches. If you experience chronic tension-type headaches or frequent tension-type headaches certain medications may stop some headaches before they start. These are antidepressants such as amitriptyline or venlafaxine or duloxetine. These work on the pain centers in the brain.
Overall, lifestyle changes and reducing your response to stress is the best way to prevent tension headaches. The most effective stress management tool is the one that fits into your life and you feel good using. You may want to try:
- Massage therapy.
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What Are The Symptoms Of Each Tension Headache
- Tension headaches are usually felt as a band or across the forehead. They can be uncomfortable and tiring, but they do not usually disturb sleep. Some people feel a squeezing or pressure on their head.
- It usually occurs on both sides, and often spreads down your neck, or seems to come from your neck. Sometimes it is just on one side.
- The pain is usually moderate or mild. Tension headaches can interrupt concentration but are usually not bad enough to send you to bed. Most people can work through a tension headache if they really need to.
- A tension headache can last from 30 minutes to seven days. Most last a few hours.
- Tension headaches tend to become worse as the day goes on and are often mildest in the morning. They are not usually made worse by physical activity.
- An exception to this would be a headache caused by sleeping in an awkward position, causing a sore neck, or an ache in the face and jaw due to tooth grinding.
- There are usually no other symptoms.
Sometimes migraines are mistaken for chronic tension headaches. Some people don’t like bright lights or loud noises, and don’t feel like eating much when they have a tension headache. However, marked dislike of light or loud noise, and visual disturbances, like zigzag lines, are more suggestive of migraine. A mild feeling of sickness can occur, especially if you are using a lot of painkillers. However, marked nausea is, again, more a feature of migraine.
When To Call The Doctor
- You are experiencing “the worst headache of your life.”
- You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms with a headache before.
- A headache starts suddenly.
Schedule an appointment or call your provider if:
- Your headache pattern or pain changes.
- Treatments that once worked no longer help.
- You have side effects from your medicine.
- You are pregnant or could become pregnant. Some medicines should not be taken during pregnancy.
- You need to take pain medicines more than 3 days a week.
- Your headaches are more severe when lying down.
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How Can I Feel Better
Most headaches will go away if a person rests or sleeps. When you get a headache, lie down in a cool, dark, quiet room and close your eyes. It may help to put a cool, moist cloth across your forehead or eyes. Relax. Breathe easily and deeply.
If a headache doesn’t go away or it’s really bad, you may want to take an over-the-counter pain reliever like acetaminophen or ibuprofen. You can buy these in drugstores under various brand names, and your drugstore may carry its own generic brand. It’s a good idea to avoid taking aspirin for a headache because it may cause a rare but dangerous disease called Reye syndrome.
If you are taking over-the-counter pain medicines more than twice a week for headaches, or if you find these medicines are not working for you, talk to your doctor.
Most headaches are not a sign that something more is wrong. But if your headaches are intense and happen often, there are lots of things a doctor can do, from recommending changes in your diet to prescribing medicine. You don’t have to put up with the pain!
Treating The Cause: Diary
It may help to keep a diary if you have frequent headaches. Note when, where, and how bad each headache is, and how long each headache lasts. Also note anything that may have caused it. A pattern may emerge and you may find a trigger to avoid. For example, hunger, eye strain, bad posture, stress, anger, etc.
Some doctors suggest reviewing your diet. The list of foods which can be triggers in some people includes caffeinated drinks, chocolate, cheese and alcohol. Other doctors suggest focusing on a healthy balanced diet, with a good mixture of slow-release energy foods and a low intake of refined sugars.
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What Causes A Tension Headache
The exact mechanism that causes a tension headache is not known. Several factors, such as genetics and environment, are thought to be involved. Muscle contractions in the head and neck are considered a major factor in the development of a tension headache. Some people get tension headaches in response to stressful events or hectic days.
When Should I Seek Help For My Headaches
Sometimes, headache can signal a more serious problem. You should talk to your doctor about your headaches if:
- You have several headaches per month and each lasts for several hours or days
- Your headaches disrupt your home, work, or school life
- You have nausea, vomiting, vision, or other sensory problems
- You have pain around the eye or ear
- You have a severe headache with a stiff neck
- You have a headache with confusion or loss of alertness
- You have a headache with convulsions
- You have a headache after a blow to the head
- You used to be headache-free, but now have headaches a lot
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What Should I Do When A Migraine Begins
Work with your doctor to come up with a plan for managing your migraines. Keeping a list of home treatment methods that have worked for you in the past also can help. When symptoms begin:
- If you take migraine medicine, take it right away.
- Drink fluids, if you don’t have nausea during your migraine.
- Lie down and rest in a dark, quiet room, if that is practical.
Some people find the following useful:
- A cold cloth on your head
- Rubbing or applying pressure to the spot where you feel pain
- Massage or other relaxation exercises
How Long Does A Tension
That depends. A tension-type headache may last for 30 minutes or months. In general, episodic tension headache symptoms tend to come on slowly and end sooner. They often happen in the middle of the day. Episodic headaches usually dont last longer than a week.
People with chronic tension-type headaches can have symptoms that last for months at a time. Pain may stay at the same level of discomfort for days. While uncommon, these headaches can take a toll on your quality of life.
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Make Sure That Your Headaches Arent A Sign Of A Serious Illness
Headaches can be a symptom of stress. Or they may be a sign of a serious physical problem. For example, a headache may be a symptom of a tumor in your brain, or of an infection of your brain or the coverings of your brain. Or of any number of serious health problems.
This means that if you have chronic headaches, the first thing to do is to go see your doctor to make sure that your headaches arent being caused by a physical illness.
You want to be sure to go see your doctor if you have a headache with any of the following qualities:
- Your headache comes on abruptly and is severe
- Your headache is accompanied by fever, a stiff neck, confusion, double vision or difficulty in speaking.
- You have a headache after a head injury.
Your doctor will take a history, do a physical examination and if necessary do blood tests and imaging studies.
If your doctor doesnt find any physical cause for your tension headaches, then you can pretty much assume that they are probably caused by stress and/or anxiety. And then you can treat them accordingly.
You can confirm for yourself that your tension headaches are probably caused by stress and/or anxiety if they have the following qualities:
- Your headaches tend to occur during periods of feeling stressed/anxious.
- Your headaches tend to occur along with other symptoms of stress or anxiety.
- Your headaches tend to come and go depending on your level of anxiety/stress.
Are There Different Kinds Of Migraine
Yes, there are many forms of migraine. The two forms seen most often are migraine with aura and migraine without aura.
Migraine with aura . With a migraine with aura, a person might have these sensory symptoms 10 to 30 minutes before an attack:
- Seeing flashing lights, zigzag lines, or blind spots
- Numbness or tingling in the face or hands
- Disturbed sense of smell, taste, or touch
- Feeling mentally “fuzzy”
Only one in five people who get migraine experience an aura. Women have this form of migraine less often than men.
Migraine without aura . With this form of migraine, a person does not have an aura but has all the other features of an attack.
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Stress Affects The Body On A Biological Level
When we think of how can stress cause headaches, we have to first look at the body on a biological level. On the most basic level, the stress response begins in the brain, which triggers the release of an adrenaline hormone known as epinephrine, which increases heartbeat, pulse, and blood pressure.
Over time, chronic stress may result in high blood pressure, and mood disorders like anxiety and depression. Some people may also develop addictions to drugs or alcohol in an effort to cope with stress, according to Harvard Health. People may turn to food to cope with the tension, stop exercising, or have difficulty sleeping. These side issues may lead to obesity or other health problems.
Types Of Anxiety Headaches
Doctors don’t have a separate name for a stress or anxiety headache. But the most common types of headaches all have a link to anxiety.
Tension headaches. Almost everyone gets one at some point. When you hear people say they have a headache, it’s usually this kind. Typically they’re not too painful.
Tension doesn’t mean stress in this case, but refers to how the headache feels, which may be like a tight band around your head. It can be triggered by anxiety, but it’s not clear why this happens.
Migraines. These are more severe headaches that can cause painful pounding or throbbing. They can last for hours or even days. Besides pain, migraines can also make you vomit and feel sensitive to light and noise. They’re very common in people who have anxiety disorders.
They’re called cluster headaches because of how they happen. You might get them a few times a day for a few weeks or months, and then they just go away. They may not come back for months or years.
People with cluster headaches are more likely to have anxiety — typically in the months of downtime between bouts of headaches. Doctors aren’t sure how cluster headaches and anxiety are connected or which one causes the other.
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I Get Migraines Right Before My Period Could They Be Related To My Menstrual Cycle
More than half of migraines in women occur right before, during, or after a woman has her period. This often is called “menstrual migraine.” But, just a small fraction of women who have migraine around their period only have migraine at this time. Most have migraine headaches at other times of the month as well.
How the menstrual cycle and migraine are linked is still unclear. We know that just before the cycle begins, levels of the female hormones, estrogen and progesterone, go down sharply. This drop in hormones may trigger a migraine, because estrogen controls chemicals in the brain that affect a woman’s pain sensation.
Talk with your doctor if you think you have menstrual migraine. You may find that medicines, making lifestyle changes, and home treatment methods can prevent or reduce the pain.
Other Health Effects Of Stress
When we ask, can stress cause headaches, we typically look at only the direct correlation between the two. However, since stress impacts other parts of the body, this damage or inflammation can in turn create unhealthier patterns or behaviors, which can again, cause headaches. As all pain doctors know, the body and mind are connected in complex ways. Well look at just a few other ways stress can affect the body and then, most importantly, ways to reduce stress to reduce pain.
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How Can Stress Cause Headaches
Everyday stress can bring on headaches in a variety of ways. Thats because stress causes us to change our behavior without even realizing it.iv
You may still experience the occasional tension headache, but practicing the above techniques should help reduce their frequency and severity. Looking for a quick and effective way to get rid of a stress headache? Try an over-the-counter headache relief medication like Excedrin.You may still experience the occasional tension headache, but practicing the above techniques should help reduce their frequency and severity. Looking for a quick and effective way to get rid of a stress headache? Try an over-the-counter headache relief medication like Excedrin.
And while relaxation therapies and simply cutting down on the stress in your life can help to reduce the occurrence of tension headaches, chronic tension headaches may be indicative of a more serious issue. Consult a doctor to discuss and learn more about your headaches.
About Your Neck Pain And Headaches
Simultaneously, muscles in our neck and scalp may contract. These muscle contractions occur when we are faced with stress, anxiety, or depression. When these muscles contract they often cause dull, nagging headaches that often turn into full-blown migraine headaches.
Robert Gotlin, DO, director of Orthopaedics and Sports Rehabilitation at Beth Israel Medical Center in New York City says this about neck pain,
As stress goes up I definitely see more patients with neck pain. Every year around tax time, the number of patients with neck pain increases, especially among Wall Street types here in New York.
Another cause of neck pain is structural and results from a neck joint issue. This type of a headache is known as a neck headache or more properly as a Cervicogenic headache. Research shows that fixing the neck can end a headache. The joints usually associated in a neck headache are:
- Atlanto-occipital joint
- Atlanto-axial joint
- C2/3 cervical spine joints
When your neck joints are too tight, a headache can result in just a few minutes. Not all stress is bad, however. Stress within your comfort level helps you to perform under pressure, keep you motivated and to keep you safe when danger is evident.
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