Overview
Tension type headache is different to migraine, and sufferers are often incorrectly diagnosed. Most people may not understand the difference between the two, and often use both terms to label their headaches incorrectly.
• Tension type headache will have mild to moderate pain, whereas migraine pain is usually more significant and can reach up to severe disabling pain.
• Tension type headache pain is usually felt bilaterally on both sides of the head, whereas migraine pain is unilaterally and felt on one side of the head
• Tension type headache does not get worse with normal every day-to-day activities and movements. However unlike acute or chronic migraines, simple movements, activities, work or even sport can often exacerbate and worsen a migraine.
Tension Type Headache
Common symptoms of tension headache include:
• Pain is bilateral and all over
• Pain is mild to moderate
• Pain is felt like a squeezing, tightening, pressure pain
• No nausea or vomiting
• Movement and activities does not worsen the headache
• No visual disturbances
• Occurs without warning
Migraine
Common symptoms of migraine include:
• Pain is unilaterally and on one side
• Pain is moderate to severe
• Pain is felt like a severe headache with throbbing and pulsating pain
• Nausea and vomiting is often present
• Movement and activities can worsen the migraine
• Visual disturbances
• Can occur with warning signs or aura
What is a tension headache?
A tension headache is a common headache disorder typically described as a mild to moderate, pressure-like or tightening sensation affecting both sides of the head. It is often felt as a band-like pressure around the forehead or a dull, steady ache across the temples or occipital region.
Tension-type headache is understood to involve increased sensitivity within pain processing pathways, which may influence how sensory input from the head and neck region is interpreted by the nervous system.
What causes a tension headache?
Tension headaches are thought to be influenced by a range of interacting factors, and presentation can vary between individuals. Common contributing factors may include psychological stress, sustained postural load, jaw muscle tension, sleep disruption, and changes in how the nervous system processes sensory input.
In some presentations, ongoing input from the upper neck region may play a role in increased sensitivity within the trigeminocervical system, which may contribute to the development or persistence of symptoms. Clinicians consider these factors within a broader headache assessment to better understand each individual’s presentation.
What does a tension headache feel like?
A tension headache is typically described as a constant, dull pressure or tightening sensation rather than a throbbing or pulsating pain. Many individuals report a “tight band” or constrictive feeling around the head, often affecting both sides equally.
It may also be associated with muscle tightness or tenderness in the neck and shoulder region, particularly during periods of stress, prolonged concentration, or sustained postural demands.
How long can a tension headache last?
A tension headache can last anywhere from 30 minutes to several days, depending on the type and frequency of the headache. Episodic tension-type headaches may resolve within the same day, while some attacks can last longer.
Chronic tension-type headaches are different. These may occur on 15 or more days per month for longer than three months, with symptoms lasting for hours, days, or becoming persistent.
If tension-type headaches are frequent, recurring, or difficult to manage, professional assessment can help identify contributing factors such as neck tension, stress load, posture, sleep disruption, or increased sensitivity within the nervous system.
How to relieve tension headache?
Management strategies for tension headaches often focus on reducing muscular load and supporting regulation within the nervous system. This may include rest in a low-stimulation environment, gentle movement, hydration, and approaches aimed at reducing neck and shoulder muscle tension.
Where symptoms are recurrent or persistent, clinicians may also assess whether increased sensitivity within upper cervical pathways is contributing to the headache pattern.
At Gold Coast Headache and Migraine Clinic™, clinicians provide a medication-free, surgery-free approach to headache management, focusing on identifying and addressing potential underlying contributors rather than relying solely on acute or preventive medications for symptom control.