Muscle Contraction Headache

Definition

A type of headache caused by tension or sustained muscle contraction. The pain is usually a steady pain and other symptoms may include a sore scalp, nausea and blurred vision.

Causes

Tension headaches occur when neck and scalp muscles become tense, or contract. The muscle contractions can be a response to stress, depression, a head injury, or anxiety.

Degenerative arthritis of the neck, temporomandibular joint dysfunction or physical postures may trigger one of these headaches.

Any activity that causes the head to be held in one position for a long time without moving can cause a headache. Such activities include typing or other computer work, fine work with the hands, and using a microscope. Sleeping in a cold room or sleeping with the neck in an abnormal position may also trigger a tension headache.

Other causes of tension headaches include:

  • Alcohol use
  • Caffeine (too much or withdrawal)
  • Colds and the flu
  • Eye strain
  • Excessive smoking
  • Fatigue
  • Nasal congestion
  • Overexertion
  • Sinus infection
Risk Factors

They may occur at any age, but are most common in adults and adolescents.

Symptoms

The headache pain may be described as:

  • Dull, pressure-like
  • A tight band or vise on the head
  • All over (not just in one point or one side)
  • Worse in the scalp, temples, or back of the neck

The pain may occur as an isolated event, constantly, or daily. Pain may last for 30 minutes to 7 days. It may be triggered by or get worse with stress, fatigue, noise, or glare.

There may be difficulty sleeping. Tension headaches usually do not cause nausea or vomiting.

Diagnosis

A headache that is mild to moderate, not accompanied by other symptoms, and responds to home treatment within a few hours may not need further examination or testing. If a neurologic (nervous system) examination is performed, a tension headache causes no abnormal findings. However, tenderness in the muscles near the skull is often present.

Treatment

There are many different treatments for tension headaches, which respond well to both medication and massage. If these headaches become chronic, however, they are best treated by identifying the source of tension and stress and reducing or eliminating it.

Medication
Tension headaches usually respond very well to such over-the-counter analgesics as aspirin, ibuprofen, or acetaminophen. However, some of these drugs (especially those that contain caffeine) may trigger rebound headaches if discontinued after they are taken for more than a few days.

More severe tension headaches may require combination medications, including a mild sedative such as butalbital; these should be used sparingly, though. Chronic tension headaches may respond to low-dose amitriptyline taken at night.


Massage
Massaging the tense muscle groups may help ease pain. Instead of directly massaging the temple, patients will get more relief from rubbing the neck and shoulders, because tension headaches can arise from tension in this area. In fact, relaxing the muscles of the neck can cut the intensity and duration of tension headaches at least in half.

To relax these muscles, the neck should be rotated from side to side as the shoulders shrug. Some people find that imagining a sense of warmth or heaviness in the neck muscles can help. Taking three very deep breaths at the first hint of tension can help prevent a headache.


Other therapy
If tension headaches are a symptom of either depression or anxiety, the underlying problem should be treated with counseling, medication, or a combination of both.

Prevention

Cutting down on stress and relying less on caffeine-containing medications can reduce the number of tension headaches for most people.

Tension headaches can often be prevented by managing everyday stress and making some important lifestyle changes. Those who are prone to tension headaches should:

  • take frequent "stress breaks"
  • get regular exercise--even a brisk 15-minute walk can help prevent tension headaches
  • get enough sleep
  • release angry feelings


Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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