Tension headache: what causes it and what helps

It starts as a dull ache by mid-afternoon and settles in like a tight band around your forehead. If that sounds familiar, it's very likely a tension headache. Healthdirect describes tension-type headache as one of the most common kinds of headache: a dull or tight pain, usually on both sides of the head, that can last anywhere from 30 minutes to 7 days.

The short answer: tension headaches are common and usually not a sign of anything serious. They tend to follow everyday things like stress, a short night, skipped meals, not enough water or long stretches at a screen. Spotting your own pattern is often the most useful thing you can do. Here's what tends to be behind them, what helps, when to see your GP, and how the Thrive Health Band and the Thrive by Optihealth app can help you see your pattern.

What a tension headache feels like

Migraine & Headache Australia describes a tension headache as mild to moderate pain on both sides of the head, often like a band tightening around it. You might also notice tender muscles around your forehead, scalp, neck or shoulders.

A few things set it apart from migraine. A tension headache usually doesn't throb, doesn't come with nausea or vomiting, and doesn't get worse when you walk or climb stairs. Migraine is more often a throbbing pain on one side of the head, sometimes with nausea, sensitivity to light or sound, or visual changes. If you're not sure which you have, your GP can help you work it out.

Common triggers

Migraine & Headache Australia notes that the exact cause of tension headache isn't known. What is well known is the list of everyday things that tend to set one off. Healthdirect's list of common headache triggers includes:

Stress. Tension headache is sometimes called a stress headache, because stress is such a common trigger. Healthdirect notes that headaches can also show up when you finally relax after a stressful stretch, which is why some people get them on the first day of a weekend or holiday. Our piece on work stress and sleep looks at how the two feed each other.

Too much or too little sleep. A short night, a very long lie-in or a big change to your usual bedtime can all play a part. See how much sleep adults need.

Long stretches at a screen. Healthdirect lists too much screen use, and Migraine & Headache Australia mentions tired eyes from long periods of reading or screen time. Here's more on screen time and how much is too much.

Posture. Hours hunched over a laptop or phone can leave your neck and shoulders tight. Regular movement breaks at work are an easy place to start.

Skipped meals and not enough water. Healthdirect names skipping meals, especially breakfast, and not drinking enough water. Dehydration headaches are usually felt all over the head.

Caffeine and alcohol. Large amounts of caffeine can trigger a headache, and so can missing your usual coffee. Alcohol can too. See how long caffeine lasts.

Often it's a mix. A late night, a deadline, a missed lunch and an afternoon at the laptop can add up to a sore head by 4pm.

What helps when one starts

For a mild headache that doesn't come often, healthdirect suggests some simple things you can try at home:

1. Have a drink of water.
2. Lie down in a dark, quiet room, or have a short sleep if you can.
3. Put a cool or warm face washer on the back of your neck or your forehead.
4. Take a walk outside in fresh air.
5. Gently stretch your neck and shoulders.
6. Try a few minutes of slow breathing. Box breathing is an easy one to learn.

Pain relief from the pharmacy can help an occasional tension headache. Healthdirect notes that using pain medicines too often can lead to more headaches, known as medication overuse headache. Your pharmacist or GP can help you use them safely.

Fewer headaches over time

The everyday habits that help most are the ones that take the edge off your common triggers. Healthdirect suggests regular meals, enough water, good posture, regular exercise, ways to manage stress, the right amount of sleep each night, and keeping alcohol and caffeine in check.

That can look like:

• A regular bedtime and wake time, even on weekends. Our sleep hygiene basics are a good place to start.
• A proper lunch on busy days, rather than coffee and a muesli bar.
• A water bottle on your desk.
• A short break from the screen every hour or so.
• A plan for stressful weeks, even if it's just a walk at lunchtime.

When to see your GP

Most tension headaches are a nuisance rather than a worry, and they settle with rest, water and time. Even so, it's always fine to check in with your GP.

Healthdirect suggests seeing your GP if your headaches are frequent and get in the way of your usual day, if you're taking pain relief for headaches often during a week, or if your headaches change or get worse.

Call triple zero (000) and ask for an ambulance, or go to your nearest emergency department, if a headache is sudden and severe, or comes with vomiting, confusion, a stiff neck or changes in your vision.

Also go straight to an emergency department if a headache comes with a fever, a change in personality, blurred or double vision, loss of balance or a seizure.

Healthdirect also suggests keeping a headache diary in the weeks before your appointment: how many days you had a headache, how bad it was, other symptoms and possible triggers. That's where Thrive can help. You can show your Thrive trends to your GP, and Ask Thrive can help you pull together what changed and when.

See your headache pattern with Thrive

The Band doesn't measure headaches. But many of the things that tend to come before one, like a short night, a stressful day or a missed meal, are things Thrive can help you see.

Log a headache when it happens. In the app you can log a headache, rate how strong it was from 1 to 10, add when it started and ended, and add a note.

See your nights clearly. Wear the Thrive Health Band to bed. It has no screen and up to 14 days of battery. Thrive shows your hours slept along with Quality, Quantity, Regularity and Timing, so you can tell a short night from a late one.

Add the context. In your Daily Check-In you can rate your mood and stress and tag your day with things like Work stress, Coffee, Alcohol or Hydration. You can log meals in the Nutrition tab too.

Over time, Thrive learns what's usual for you right across your health, from sleep, heart, temperature and activity to mood, stress, meals, medications and symptoms. Your Health Fingerprint is ready after about 30 days of wear. Then you can ask Ask Thrive questions like:

• "Do my headaches come after short nights?"
• "Did I log more headaches in stressful weeks?"
• "How many headache days did I have this month?"

Before you buy

Thrive Health Band: A$589 for the band including 12 months of the Thrive plan, paid upfront. Prices are in AUD and include GST.

Free shipping. Your 12 months start when you activate your Band, and there's no automatic renewal.

At renewal: a new band plus 12 more months for A$589.

Or keep your band and renew the plan for A$240 a year.

Or A$29 a month with no lock-in.

One size, IP68, up to 14 days battery, 12-month warranty, not a medical device, no Apple Health sync. The app is Thrive by Optihealth on iPhone and Android.

See today's price on the Thrive store

Consumer guarantees under Australian Consumer Law always apply. See Returns if something is wrong with your purchase.

Common questions

How long does a tension headache last?

Healthdirect says a tension-type headache can last anywhere from 30 minutes to 7 days. If yours keep coming back or change, see your GP.

Is a tension headache the same as a migraine?

No. A tension headache is usually a dull, tight ache on both sides of the head. Migraine is more often throbbing, on one side, and can come with nausea or sensitivity to light and sound.

Can lack of sleep cause a headache?

It can. Healthdirect lists too much or too little sleep among common headache triggers.

For more answers, see Questions.