Tension headaches

What are tension type headaches?

Tension type headaches (TTH) affect 80% of the UK population (Steiner et al, 2010).


• The exact cause of TTH is not fully understood and is thought to be multifactorial.
• One commonly accepted theory is that it the pain results from sustained tension from the neck and scalp muscles, however studies have also shown that TTH can still exist without the muscular tension (Porth 2007). These are often referred to as cervicogenic headaches.
• Overactive pain pathways. This is called central sensitisation of the central nervous system where inadequate endogenous antinociceptive circuitry has been shown (Kaniecki, Robert, 2012)
• They are often associated with psychogenic stress or muscular stress.


These are characterised by:

• Mild to moderate pain
• Sensation of a tight band around the head
• Lasts 30 minutes to several days
• May be worse at the end of the day.


• Analgesics such as aspirin, paracetemol and NSAIDs
• Behavioural and psychological interventions
• Acupuncture has been shown to provide pain relief and prevent TTH. From September 2012, NICE guidelines now recommend a course of acupuncture as a form of treatment for TTH prevention.