Last week, in Part 1 of Headaches are a REAL Pain, Karey and I discussed migraine and cluster headaches. This week will be focusing primarily on Tension-Type Headaches. Then we’ll briefly address ‘Secondary’ Headaches.

Currently, in traditional medicine, the symptoms of a headache are broken into two primary categories, ‘primary’ and ‘secondary.’ The headaches that fall under ‘primary’ include Tension Type, Migraine, Cluster, and Trigeminal Neuralgia. Primary headaches are thought to be the result of dilated blood vessels in the head that activate or put pressure on a facial nerve called the Trigeminal nerve.

(For information on Migraine and Cluster Headache, please check out Headaches are a REAL Pain: Part 1.)

Tension-Type Headaches (Tension Headaches)

Tension Headaches are the MOST common primary headache. We don’t exactly know the cause of tension headaches (meaning we don’t know the biochemical process), but we do know that, in general, a tension-type headache is due to muscle contractions of the head and neck region. Other considerations include how the nerves of the head, neck, and shoulders sense pain and changes in the brain’s interpretation of pain signals that are sent from the muscles in the head and neck.

Facts About Tension Headaches

  • According to the World Health Organization, up to 70% of the world’s population experience episodic tension-type headaches.
  • Episodic headaches occur on or fewer than 15 days per month.
  • Approximately 1-3% of the world’s population is affected by chronic tension-type headaches or a tension headache that occurs on more than 15 days out of every month.
  • Episodic tension-type headaches can last 30 minutes or up to a week.
  • Tension-type headaches typically begin during the teenage years and are more common in women than men.
  • The symptoms of a tension-type headache are typically characterized by a feeling of pressure or tightness around the head, including the forehead.
  • Typically, unlike migraine headaches, the pain is felt on both sides of the head and can include the muscles of the neck.
  • The muscles of the head and neck can be tender to touch.
  • Unlike migraine headaches, tension headaches typically are not associated with vision changes, nausea, vomiting, or tingling of the hands, although some people have reported nausea on occasion.

Several things can trigger muscle contractions that lead to tension headaches.

Common triggers include: 

  • Physical or emotional stress
  • Holding the head and neck in the same position for a long period of time
  • Prolonged eye strain
  • Abnormal positioning of the neck during sleep
  • Sleeping in too cold of a room
  • Lack of quality sleep
  • Arthritic issues such as degenerative disc disease or spondylosis of the cervical (neck) spine
  • Decreased water intake
  • Caffeine (excessive use or withdrawal)
  • Alcohol
  • Skipping meals/fasting
  • Certain foods (especially those containing MSG and tyramine)

* Karey Thomas, FNTP, will be sharing her thoughts on these and more later this week.


Traditionally Treatments for Tension-type Headaches

1. Anti-inflammatories

  • Over the counter the anti-inflammatories (aka NSAIDs): Ibuprofen, Advil, Motrin, and Aleve
  • Prescription anti-inflammatories: Mobic, Celebrex, Naprosyn, Diclofenac, and Lodine to name a few

A few warnings. NSAIDs can decrease or impair normal kidney function, increase blood pressure, irritate the stomach, increase risk of bleeding, and cause leg swelling. So use caution. 

2. Tylenol (Acetaminophen) (warning: Tylenol can affect or impair liver) 

3. Excedrin (Tylenol, aspirin, and caffeine combination)

4. Muscle relaxants

5. Lidocaine injections into tender muscle point

6. Physical therapy

7. Narcotics

A couple of #LiveYourValue options that I would prefer we use prior to the options listed above (with the exception of physical therapy) include:

  1. Making choices that reduce stress 
  2. Improving posture 
  3. Diet and beverage modification 
  4. Increasing water intake
  5. Massage therapy
  6. Biofeedback/Meditation
  7. Vitamin B-2, Magnesium
  8. Acupuncture
  9. Low dose naltrexone trial
  10. CBD oil trial

Secondary Headaches

So, now that we touched base on migraines, cluster, and tension-type headaches, let’s chat about ‘secondary’ headaches. A ‘secondary’ headache is one that is the result of an underlying medical issue. In other words, a “symptom” of a physical imbalance that has either not been addressed, controlled, or cured.

Causes of Secondary Headaches:

  1. Bleeding in the brain (hemorrhage)
  2. Tear of an artery (blood vessel)
  3. Brain tumors
  4. Infections affecting the brain and spinal cord (meningitis/encephalitis)
  5. Stroke
  6. Systemic infections like sinus or severe pneumonia
  7. Hypertension
  8. Glaucoma
  9. Inflammatory blood vessel disease (Vasculitis)
  10. Obstructive Sleep Apnea
  11. Substance use/withdrawal/dietary choices
  12. Medications 

The treatment for a headache from a secondary cause is the same as the treatment plan for primary headaches. Additionally, you should address/improve the underlying physical imbalance (medical condition).

I hope this helps!

Remember, the choices we make do impact all that our lives are, no matter if we want to improve our physical or emotional health. After all, it’s hard not to have a headache if I’m not living my value.

So, today and every day, live your value one choice at a time.