2222 Bancroft Way University Health Services University of California, Berkeley Berkeley, CA 94720-4300 Tang Center Medical Appointments 510/642-2000 www.uhs.berkeley.edu Urgent Care 510/642-3188 Tension Headache Fact Sheet What are Tension Headaches? Tension headaches are the most common form of headaches. They are caused by muscle tightening in the back of the neck and/or scalp, often triggered by emotional stress, fatigue, or depression. There are two classifications of tension headaches. Episodic tension-type headaches occur randomly and less frequently. Chronic tension-type headaches are daily or continuous headaches where the intensity of the pain may vary during a 24-hour cycle. The Symptoms § Tight feeling in head or neck muscles § A tightening band-like sensation around the neck and/or head which is a “vice-like” ache § A constant dull, achy feeling on both sides of the head § Pain that primarily occurs in the forehead, temples or the back of the head and/or neck § Chronic tension-type headaches may also be accompanied by changes in sleep patterns or insomnia, early morning or late day occurrence of headache, feelings of guilt, weight loss, dizziness, poor concentration, ongoing fatigue, or nausea. When to See a Clinician § If you’re getting frequent, debilitating headaches that are interfering with your routine § If you’re taking an excessive amount of pain relievers § If you have a severe or constant headache that begins suddenly and is accompanied by weakness, dizziness, numbness or other strange sensations (call your clinician or Urgent Care immediately) § If you’re experiencing a change in headache frequency, intensity, or pattern. Diagnosis and Treatment A clinician often can tell what kind of headache you have by examining you and hearing your description of the pain. Generally, blood tests, x-rays or brain scans are not needed. To aid in a proper diagnosis and to communicate efectively with your clinician, it’s wise to keep a diary on your specific headache patterns and bring it to your appointment. A sample headache diary is attached. For occasional tension headaches, over-the-counter (available without a prescription) pain relievers such as aspirin, acetaminophen, ibuprofen or naproxen sodium can help. Withdrawal from the source of stress or a relatively brief period of relaxation may also make the headache disappear. If you have tension headaches almost every day (even if pain relievers are helping) or the above treatments don’t help with the pain, your clinician may prescribe other treatments for you. It’s best to treat tension headaches when they begin. This not only helps them from getting worse, but they’re more likely to disappear when treated immediately. Other Headache Types Below are four other types of headaches. If you feel you have one of these, we recommended you contact University Health Services. § Sinus headaches are caused by infection or inflamed sinuses and are characterized by a gnawing pain that develops in the nasal area, with increased severity as the day goes on. § Cluster headaches are characterized by severe pain that develops behind one eye and may be triggered by excessive smoking and/or alcohol consumption. § Migraine headache symptoms can include severe pain on one side of the head, pain with a pulsating or throbbing quality, sensitivity to light and sound, nausea or vomiting, and increased pain with exertion (e.g. climbing stairs). Approximately one-fifth of migraine sufferers also experience auras. An aura is characterized by the appearance of warning signs 30-60 minutes before the onset of headache symptoms. Aura symptoms are 2222 Bancroft Way University Health Services University of California, Berkeley Berkeley, CA 94720-4300 Tang Center Medical Appointments 510/642-2000 www.uhs.berkeley.edu Urgent Care 510/642-3188 usually neurologic in nature and may include visual disturbances (e.g. seeing wavy lines, dots, flashing lights, blind spots) and disruptions in smell, taste, or touch. § Post-traumatic headache can result from head injury and may persist for months or years following even mild head trauma. The most common symptoms are head pain, dizziness, insomnia, poor concentration, and mood and personality changes. Headache Self-care § Put a heat pack or ice pack on your head or neck. § Take a hot shower. § Get enough rest or sleep. Maintain consistent sleep patterns, including on weekends and holidays. § Get regular exercise. A routine of 20-40 minutes of aerobic exercise 3 or more times per week can relieve stress and balance internal physiology. § Eat regular meals, and do not skip meals. Eat a good, healthy breakfast. § Drink plenty of fluids to avoid dehydration. § Take time away from things that are stressful when you can. Also, try stress management techniques. Stress Management Strategies Emphasis Examples Relaxation Listening to music, spending time in nature, meditation, yoga, Tai Chi, Qi Gong, massage, breathing exercises Managing emotions Exercise, journal writing, creative activities, mindfulness Managing thoughts Thought-stopping techniques, mindfulness, positive thinking Managing obligations Time management, breaking large tasks into small pieces, goal setting, assertiveness Connections with others Time with friends, family, community, pets Headache Resources University Health Services § Medical appointment. (call 510.642.2000) § Health education appointment on stress, time and pain management. (call 510.642.2000) § Self-Care Resource Center: information on migraines, stress reduction, relaxation, medication & more. (2nd floor, M-F 11am-4pm) § Counseling for academic, personal and career concerns. (3rd floor or call 510.642.9494) Websites § www.uhs.berkeley.edu § American Council for Headache Education: www.achenet.org § National Headache Foundation: www.headaches.org Other § The American Council for Headache Education provides a listing of on-line and local support groups. Visit www.achenet.org § An on-line headache diary is available at http://www.achenet.org/your/diary1.php § Low-cost acupuncture treatment is available near campus at the Meiji College Clinic of Oriental Medicine. (510.666.8234) § Low-cost massage is available at the National Holistic Institute in Emeryville. (510.547.6442). § An 8-week stress reduction and chronic pain care course is available in Berkeley through StressCare. (510.540.8928) § CalFit Program at the campus Recreational Sports Facility (RSF) offers yoga, Tai Chi, Qi Gong, and Accupressure classes and massage services. (510.643.5151) Rev. 9/18/02