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Tension headaches

Tension headaches are very common and most people get them. You can treat them yourself with painkillers but see a GP if you have several headaches a week or they're severe.

Check if it's a tension headache

Common symptoms of tension headaches include:

  • pain on both sides of your head, face or neck
  • feeling like something is pressing on your head or being tightened around it
  • the affected area may feel tender and your head may hurt more when touched

You should be able to continue doing daily activities without making the headache worse.

Tension headaches last at least 30 minutes but they can last much longer, sometimes for several days.

Causes of tension headaches

Common causes of tension headaches include:

  • stress
  • sleep problems
  • caffeine

Taking painkillers for headaches too often or for a long time can also cause headaches. These are known as overuse or rebound headaches.

Tension headaches are not a sign of an underlying condition.

How to ease a tension headache

There are some things you can do to treat a tension headache yourself.

Do

  • use painkillers like paracetamol, aspirin and ibuprofen – paracetamol is the first choice of painkiller if you're pregnant, and children under 16 should not take aspirin

  • try doing activities to help you relax like exercise, yoga and massage

  • try changing your sleeping habits if sleep problems like insomnia may be causing your headaches

  • try using a low, firm pillow and heat or cold packs if you have neck pain and headaches

Don’t

  • do not have, or cut down on, drinks with caffeine in them like tea, coffee or cola

A pharmacist can help with headaches

You can ask a pharmacist about:

  • the best painkiller to take, if you're not sure which is suitable for you
  • what to do if you're pregnant – some medicines (like ibuprofen) are not recommended in pregnancy
  • medicines for sleep problems like insomnia if you're having trouble sleeping and you think it may be causing your headaches

Non-urgent advice: See a GP if:

  • you get headaches several times a week or they're severe
  • painkillers and activities to help you relax do not help your headaches
  • you have a throbbing pain at the front or on 1 side of your head
  • you feel sick, vomit and find light or noise painful

These can be signs of a different type of headache, such as a migraine or cluster headache.

What we mean by severe pain
Severe pain:
  • always there and so bad it's hard to think or talk
  • you cannot sleep
  • it's very hard to move, get out of bed, go to the bathroom, wash or dress
Moderate pain:
  • always there
  • makes it hard to concentrate or sleep
  • you can manage to get up, wash or dress
Mild pain:
  • comes and goes
  • is annoying but does not stop you doing daily activities
Information:

Coronavirus (COVID-19) update: how to contact a GP

It's still important to get help from a GP if you need it. To contact your GP surgery:

  • visit their website
  • use the NHS App
  • call them

Find out about using the NHS during COVID-19

What happens at your GP appointment

If you have regular tension headaches, a GP may suggest you keep a headache diary to record details of your headaches like:

  • how often you get them and how long they last
  • how painful they are and any other symptoms you have
  • possible causes
  • any medicines you take to help

The GP may advise you about taking painkillers for tension headaches, such as when to take medicine and how often you should take it.

You may be referred to a specialist if painkillers and activities like exercise do not help reduce your headaches or if it's not clear what's causing them.

Preventing tension headaches

If you get tension headaches regularly, you may be offered a course of acupuncture.

An antidepressant medicine called amitriptyline is also sometimes recommended to help prevent tension headaches.

You'll be prescribed a low-dose to start with, which may later be increased. The medicine usually needs to be taken for several months before it starts working.

Page last reviewed: 04 March 2022
Next review due: 04 March 2025