The most common headache

The most common type of headaches by far are tension headaches. About 90% of headaches fall into this category. When you experience a tension headache, you typically feel like there’s  a rubber band wrapped too tightly around your head. The pain level can vary from a mild throbbing to fairly severe – in the worst cases, pain spreads from the head and covers the shoulders, neck and upper back. Other unpleasant symptoms may also be present. For example, your scalp, neck and shoulder may be sore and painful to touch. You may also feel extremely tired and easily irritated, and you may have to struggle to concentrate. Insomnia and a lack of appetite are also common symptoms.

Depending on how often you experience them, tension headaches can be broken down into 3 different classifications. Episodic headaches are usually sporadic and occur less than once a month. Frequent tension headaches happen 1-5 times in a given month. The most frequent type of tension headache is classified as chronic.  These can occur 15 or more days per month, which means that sufferers of this type of headache are in pain for at least half of their waking hours.


What causes a tension headache? As far as the biomechanical mechanisms that make you feel pain are concerned, there are two schools of thought. The first school of thought states that tension headaches are primarily caused by…tension. This theory holds that such factors as stress and anxiety cause muscles in your face, neck and scalp to tense up, causing your headache. However, some researchers today believe that tension headaches don’t come from muscle tension at all, but rather from imbalances in brain chemicals and neurotransmitters.

For example, researchers are now able to use special machine called an electromyogram to measure muscle contractions, and they have not found a pattern of increased muscle tension that is specific to tension headaches. People with tension headaches are found to be tense, but not any more or less tense than people with migraines. Additionally, they show alterations in the levels of two very important types of brain chemical: serotonins and endorphins.

Serotonin helps the brain control mood, sleep and appetite, and serotonin imbalances can also cause clinical depression. Endorphins are the body’s natural painkillers. Changes in the levels of these chemicals interfere with the body’s ability to control pain, and are found in people with both tension headaches and migraines.

No one is sure what causes these changes in brain chemicals. The only thing researchers are certain of right now is that there is a connection between altered levels of these neurotransmitters and various types of headache. However, muscle tension may still be a major contributing factor to tension headache.

Tension Headache Triggers

Whatever the precise mechanism is that produces the headache, tension headaches are known to have a variety of different “triggers.” Exposure to any one of these triggers can lead to a headache, but different people are sensitive to different “triggers.” Here is a list of possible triggers – as you read it, think about the headaches you experience and see if any of these triggers apply to you:

  • Stress, depression or anxiety – Heightened emotions, whether they are caused by emotional disorders such as clinical depression or simply from stressful life situations, can trigger headaches in susceptible individuals.
  • Lack of sleep, fatigue or overexertion – anything that causes extreme exhaustion can also make you more susceptible to a headache. 
  • Hunger – Skipping meals or eating at irregular hours gives some people a nasty headache! 
  • Bad posture – Day-to-day poor posture or any activity that has you holding your head or neck in an awkward or uncomfortable position for a long time will contribute to a headache. 
  • Eye strain – Staring at a computer screen for too long or reading in poor light leads to headaches for some people. 
  • Not getting enough exercise 
  • Excessive smoking, alcohol or caffeine use 
  • Arthritis and TMD – Both arthritis of the neck and TMD, a disorder that causes excessive jaw clenching, can trigger tension headaches. 
  • Colds, sinus infections, and nasal congestion – Anyone who’s ever had a bad cold can attest to this trigger. 
  • Overuse of over-the-counter pain relievers can cause a “rebound headache.”