A tension-type headache causes mild to moderate pain that's often described as feeling like a tight band around the head. A tension-type headache is the most common type of headache, yet its causes aren't well understood.

Treatments are available. Managing a tension-type headache is often a balance between practicing healthy habits, finding effective nonmedicine treatments and using medicines appropriately.


Symptoms of a tension-type headache include:

  • Dull, aching head pain.
  • Feeling of tightness or pressure across the forehead or on the sides and back of the head.
  • Tenderness in the scalp, neck and shoulder muscles.

Tension-type headaches are divided into two main categories — episodic and chronic.

Episodic tension-type headaches

Episodic tension-type headaches can last from 30 minutes to a week. Frequent episodic tension-type headaches occur less than 15 days a month for at least three months. This type of headache can become chronic.

Chronic tension-type headaches

This type of tension-type headache lasts hours and may be constant. Chronic tension-type headaches occur 15 or more days a month for at least three months.

Tension-type headaches versus migraines

Tension-type headaches can be hard to tell apart from migraines. And if you have frequent episodic tension-type headaches, you also can have migraines.

But unlike some forms of migraine, tension-type headaches usually aren't associated with visual disturbances such as seeing bright spots or flashes of light. People with tension-type headaches also don't usually experience nausea or vomiting with head pain. While physical activity tends to make migraine pain worse, it doesn't affect tension-type headache pain. Sometimes a tension-type headache occurs with sensitivity to light or sound, but this symptom isn't common.  

When to see a doctor

Make an appointment with a health care professional

See your health care professional if you need to take medicine for tension-type headaches more than twice a week. Also make an appointment if tension-type headaches disrupt your life.

Even if you have a history of headaches, see your health care professional if the headache pattern changes. Also see your care professional if your headaches suddenly feel different. Occasionally, headaches may be caused by a serious medical condition. These can include a brain tumor or rupture of a weakened blood vessel, known as an aneurysm.

When to seek emergency help

Get emergency care if you have any of these symptoms:

  • A sudden, very bad headache.
  • Headache with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking.
  • Headache after a head injury, especially if the headache gets worse.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.


The cause of tension-type headaches is not known. In the past, experts thought tension-type headaches were caused by muscle contractions in the face, neck and scalp. They thought the muscle contractions were a result of emotions, tension or stress. But research suggests that muscle contraction isn't the cause.

The most common theory is that people who have tension-type headaches have increased sensitivity to pain. Muscle tenderness, a common symptom of tension-type headaches, may result from this sensitized pain system.


Stress is the most commonly reported trigger for tension-type headaches.

Risk factors

Most people experience a tension-type headache at some point in their lives. However, some research has found that women are more likely to have frequent episodic tension-type headaches and chronic tension-type headaches. Age also might play a factor. One study found that episodic tension-type headaches were more likely to affect people in their 40s.


Because tension-type headaches are so common, they can have an effect on job productivity and quality of life, particularly if they're chronic. Frequent headache pain may make it hard to attend activities. You might need to stay home from work. If you do go to your job, it may be hard to function as usual.


Regular exercise can help prevent tension-type headaches. Other techniques also can help, such as:

  • Biofeedback training. This training teaches you to control certain body responses that help reduce pain. A device monitors and gives you feedback on your muscle tension, heart rate and blood pressure. You then learn how to reduce muscle tension and slow your heart rate and breathing.
  • Cognitive behavioral therapy. This type of talk therapy may help you learn to manage stress. Doing this may help you have fewer or less painful headaches.
  • Other relaxation techniques. Anything that helps you relax may help your headaches. This can include deep breathing, yoga, meditation and progressive muscle relaxation. You can learn these methods in classes or at home using books or apps.

Using medicines along with stress management may be more effective than any one treatment in reducing your tension-type headaches.

Also, living a healthy lifestyle may help prevent headaches:

  • Get enough, but not too much, sleep.
  • Don't smoke.
  • Stay physically active.
  • Eat regular, balanced meals.
  • Drink plenty of water.
  • Limit alcohol, caffeine and sugar.

Sept. 26, 2023
  1. Jankovic J, et al., eds. Headache and other craniofacial pain. In: Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed July 3, 2023.
  2. Kellerman RD, et al. Nonmigraine headache. In: Conn's Current Therapy 2022. Elsevier; 2022. https://www.clinicalkey.com. Accessed July 3, 2023.
  3. Togha M, et al., eds. Tension-type headache. In: Headache and Migraine in Practice. Elsevier; 2022. https://sciencedirect.com. Accessed July 3, 2023.
  4. Kang W-L, et al. Acupuncture of tension-type headache: A systematic review and meta-analysis of randomized controlled trials. Frontiers of Neurology. 2023; doi:10.3389/fneur.2022.943495.
  5. Headache classification committee of the International Health Society (HIS). The international classification of headache disorders, 3rd edition. Cephalalgia. 2018; doi:10.1177/0333102417738202.
  6. Headache. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research. Accessed July 3, 2023.
  7. Taylor FR. Tension-type headache in adults: Pathophysiology, clinical features, and diagnosis. https://www.uptodate.com/contents/search. Accessed July 3, 2023.
  8. Ropper AH, et al. Headache and other craniofacial pains. In: Adams and Victor's Principles of Neurology. 11th ed. McGraw Hill; 2019. https://accessmedicine.mhmedical.com. Accessed July 3, 2023.
  9. Loscalzo J, et al., eds. Migraine and other primary headache disorders. In: Harrison's Principles of Internal Medicine. 21st ed. McGraw Hill; 2022. https://accessmedicine.mhmedical.com. Accessed July 3, 2023.
  10. Headaches: What you need to know. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/pain/headachefacts.htm. Accessed July 3, 2023.
  11. Taylor FR. Tension-type headache in adults: Preventive treatment. https://www.uptodate.com/contents/search. Accessed July 3, 2023.
  12. Goldman L, et al., eds. Headaches and other head pain. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed July 3, 2023.


Associated Procedures

News from Mayo Clinic

Products & Services