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Michigan Head & Neck Institute

TMJ Blog

04. 19. 2017


What Are Tension Headaches?

Accounting for about 50% of headaches, tension-type headaches are the most common type. You will sometimes hear these referred to as “muscle contraction headaches”. Although women are more likely than men to get these, pretty much everyone will have at least one tension headache at some point in their life.

The pain reported with tensions headaches is usually mild-to-moderate in intensity, with a continual pressing/tightening feeling. Some people state that it feels like their head is being squeezed. Tension-type headaches are typically not accompanied by nausea and/or vomiting.

Tension headaches are classified into 4 types:

  • Frequent episodic tension-type headache – occurs at least once/month, but not more than 15 days per month, for at least 3 months. These last anywhere from 30 minutes up to 7 days.
  • Infrequent episodic tension-type headache – at least 10 headaches that occur less than 1 day per month. Quality of life typically is not affected by these headaches.
  • Chronic tension-type headache – occurs at least 15 days per month for a minimum of 3 months. These persist for hours and can be continuous.
  • Probable tension-type headache – these headaches may be classified as probable frequent episodic, probable infrequent episodic, or probable chronic. They have basically the same symptoms of tension-type. (Probable chronic tension-type headaches can be related to medication overuse).

Symptoms of tension-type headaches include a tight feeling around the head, shoulder pain, neck pain, and sometimes even light or noise sensitivity.  The pain is typically steady, not throbbing or pulsing.

Tension headaches and migraines have some similar characteristics, so people tend to think they have migraines when they actually don’t. Some key differences are:

  • Migraine pain involves a pulsating, throbbing pain
  • Migraine pain often affects only one side of the head (tension-type typically affects both sides of the head)
  • Migraine headaches are often accompanied by nausea/vomiting & sensitivity to light/sound



Tension-type episodes are rarely disabling and do not usually require emergency treatment. Chronic tension headaches, however, can have a negative impact on your quality of life.  For many suffering from chronic tension-type headaches, depression and anxiety also come into play.  Stress can trigger or aggravate these headaches as well.

Common triggers for tension-type headaches:

  • Physical activity or Over activity – athletics or other intense physical exertion (even sexual activity) can trigger tension headaches. Alternatively, lack of activity can also be a cause.
  • Foods and Beverages – rapidly consuming very cold foods/beverages can trigger tension headaches. Keep in mind that “brain freezes” brought on by ice cream are NOT tension headaches. Skipping meals can also be a source of these as well.
  • Fatigue – lack of sleep is a headache trigger.
  • Medications – many persistent headaches are the result of medication overuse. On the other hand, withdrawal from caffeine, nicotine or alcohol can also trigger headaches.
  • Poor posture – sleeping in an uncomfortable position or working at a computer all day hunched over, straining your eyes is another common trigger.
  • TMJ Dysfunction (TMD) – jaw clenching or grinding (during the day or overnight) triggers headaches. Splint therapy to address the underlying TMJ disorder addresses the chronic headache issue.

Tension-type headaches can usually be treated and prevented.  It is more likely that patients who experience tension-type headaches ONLY will not have them for more than 1-2 years.  Patients who experience migraines in addition to tension-headaches are up against much greater challenges.  Over-the-counter pain relievers like Advil or Ibuprofen are the most popular choices (NSAIDs), followed by Aleve (naproxen).  Many patients also report that caffeine helps as well as massage therapy.  More aggressive treatments include things like stress management therapy, drug treatment with antidepressants, and relaxation training.

For more information on tension-type headaches, or if you are currently suffering from tension headaches, please contact our office at (586) 573-0438.


Medical News Today. (16 May 2006). Study suggests tension headache may actually be TMJD.

Temporal change in headache and its contribution to the risk of developing first-onset temporomandibular disorder in the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study

Pain:  January 2017 – Volume 158 – Issue 1 – p 120–129

Sanders AE, Ohrbach R. General health status and incidence of first-onset temporomandibular disorder: OPPERA prospective cohort study. J Pain.

Macfarlane TV, Glenny AM, Worthington HV. Systematic Review of Population-based Epidemiological Studies of Orofacial Pain. J Dent. 2001; 29:451–46.

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The contents of this website, such as text, graphics, images, and other materials are for informational purposes only. While there are many commonalities among multiple TMD and sleep apnea cases, each patient is unique. Information on this website should be used to educate the reader about what they should discuss with their doctor if they are suffering from the listed symptoms. The information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician or you may call our office with any questions you may have regarding TMD or sleep apnea. If you think you may have a medical emergency, call your doctor or 911 immediately.

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