At some point, everyone will have a headache, whether it’s caused by stress, lack of sleep, hormones, or even self-induced after having way too much fun the night before! For the most part, headaches are not indicative of a dangerous underlying condition, but they can be (…a topic for a future article). The focus of this article is to discuss the most common form of headache: the tension-type headache.

Tension-type headaches (TTHA) are defined by the Mayo Clinic as “a diffuse, mild to moderate pain that’s often described as feeling like a tight band around your head.” Ironically, even though this is the most common form of headache, the causes of TTHA are not well understood. These are sometimes described as muscle contraction headaches but many experts no longer think muscle contractions are the cause. They now feel that “mixed signals” coming from nerve pathways to the brain are to blame and may be the result of “overactive pain receptors.”

Regardless of the cause, the triggers of tension headaches are well known and include stress, depression/anxiety, poor posture, faulty/awkward work station set-ups, jaw clenching, and many others. Risk factors for TTHA include being a woman (studies show that almost 90% of woman experience tension headaches at some point in life) and being middle aged (TTHAs appear to peak in our 40s, though they are not limited to any one age group). Complications associated with TTHAs may include job productivity loss, family and social interaction disruption, and relationship strain. The diagnosis is typically made by excluding other dangerous causes of headaches and when all the test results return “normal,” the diagnosis of TTHA is made.

Strategies for managing TTHAs include:

• Heat and/or cold is often helpful as some patients prefer one over the other. Alternating between ice and heat is sometimes the most effective approach.
• Controlling stress by trimming out less important duties or “…taking on less” can help as well.
• Yoga, meditation, biofeedback and relaxation therapy.
• An “ergonomic” assessment of a workstation and how it “fits” the headache patient can also yield great results.
• Other highly effective therapies include acupuncture, massage therapy, behavior and/or cognitive therapy as well as of course, chiropractic!

Chiropractic is a GREAT choice compared to standard medical care, especially when side effects to medications exist. This is because manipulation of the cervical spine addresses the cause of the headache and doesn’t just try to “cover up” the pain. In 2001, Duke University reported compelling evidence that spinal manipulation resulted in almost immediate improvement for those with headaches that originate in the neck with significantly fewer side effects and longer-lasting relief compared to commonly prescribed medication. Chiropractic treatment approaches include (partial list): spinal manipulation, trigger point therapy, mobilization techniques, exercise training, physical therapy modality use, dietary and supplementation education / advice, lifestyle coaching, and ergonomic assessments.