Tension Headaches and Neck Pain

tension headache and neck painTension headaches and neck pain are very common but many people, and their physicians, neglect to find out the underlying cause meaning that treatments for tension headaches and neck pain are either unsuccessful or never applied. The pain in a tension headache will usually commence at the back of the head and move forwards, engulfing the scalp, creating a sensation of tightness across the head, and maybe even extending into the neck and shoulders. Some tension headaches and neck pain are connected topostural issues such as standing or sitting in a specific position for a long period of time. Knowing when to see your physician about tension headaches and neck pain is important as they could be symptoms of a serious underlying illness. Chronic tension headaches and neck pain can be highly debilitating and patient often try a variety of remedies to obtain relief.

Chronic Tension Headaches

When headaches occur over more than fifteen days in a month for several months they will be classed as chronic tension headaches, as opposed to episodic tension headaches that occur less frequently. The start of a tension headache is usually slow and so it may be that a dull ache at the base of the skull spreads up and over the scalp leaving a feeling of banding around the head. The neck muscles, as well as the shoulders and jaw, can start to feel tight and sore. The symptoms are usually bilateral and sufferers of tension headaches and neck pain may feel nauseous, resulting in difficulties eating and remaining well-nourished. Sleeping difficulties can compound the problem, especially where neck pain prevents sleep. Neck pain pillows and relaxation techniques can help some patients.

Headaches Triggers

Usual treatments for tension headaches and neck pain include lifestyle changes to avoid any identified triggers, the use of relaxation therapy, psychotherapy, and both prescription medications and natural remedies for headaches and neck pain. There is rarely an identifiable defect in the cervical spine triggering the tension headaches and neck pain but where this is established it may be that chiropractic treatment or even neck surgery can be of benefit. Ischaemia and spinal nerve compression could trigger headaches and neck pain but the more common causes are stress, posture, and strain.

Pinched Nerve in Neck and Headache

Tension headaches could be due to muscle tension causing nerve compression or ischaemia.

Tension Headaches and Serotonin

Some patients find that their tension headaches and neck pain are connected to neurotransmitters such as serotonin and dopamine. These affect the function of the muscles and may lead to tension in the jaw, shoulders, and neck. Migraines are sometimes aided by the use of drugs that act on the serotonin levels in the brain, keeping them steady so as to avoid migraines associated with peaks and troughs of the neurotransmitter. Some patients find that natural migraine remedies, such as feverfew, also aid tension headaches and avoid the headache leading to neck pain. In other cases it is helpful to target the neck pain before it leads to a tension headache.

Causes of Tension Headaches and Neck Pain

Those who work at computers, who sleep or work in a draughty room, and/or who have suffered whiplash or other cervical spinal trauma are thought more likely to develop tension headaches and neck pain. Eye strain can also create these symptoms, particularly as you may inadvertently strain your neck forward to see better, causing an extra ten pounds of weight on your neck for each inch your head projects forward. Maintaining healthy blood sugar is also important to avoid headaches and neck pain, and it may help to have your teeth examined if you suffer frequently from headaches and neck pain.

TMJ, Tension Headaches, and Neck Pain

Clenching the jaw is a key contributor to neck pain and headaches as this can put stress on all the muscles in the jaw and face, as well as transferring pain and stress to the neck muscles and the head. Some people grind their teeth without realizing (the dentist should be able to detect this), and a bite splint, or bite guard for use during sleep, can help to correct abnormal stress on the jaw. Unfortunately, in some cases, a bite guard can worsen the problem by increasing the strain on the jaw so it is important to discuss this with the physician and dentist prior to trying this potential remedy. The symptoms of temporomandibular joint syndrome are varied and may include issues that seem disconnected from the jaw, such as arm pain, tension headaches, and even visual disturbances.

Other key changes to consider when dealing with tension headaches and neck pain include:


  • The use of headache medications that could be producing rebound headaches
  • Additives in food that may trigger your headaches, such as sulphites or MSG
  • Specific foods that can trigger headaches, such as cheese and chocolate
  • Oestrogen levels – during menopause, menstruation, or pregnancy, these can change abruptly and trigger headaches
  • Alcohol, drug abuse, skipping meals, being overworked, all of which can be connected

Is it Serious?

Differentiating migraines and tension headaches can be difficult and sinus headaches are also sometimes similar in nature to both, making diagnosis even more complex. Physical examination of the head, neck, eyes, sinuses, and the mouth may reveal some anatomical issue, or an infection, that is causing the symptoms of tension headaches and neck pain. Memory deficits and neurological deficits may also be tested for during an examination, and patients may have trigger points pressed to see if they have tender spots that could indicate a differential diagnosis with a condition such as fibromyalgia.

Diagnosing Tension Headaches and Neck Pain

Where tension headaches and neck pain persist the physician may decide that a CT scan or MRI is warranted to rule out such things as tumors, ischaemia, or an aneurysm. X-Rays can also help to rule out cervical spinal problems such as pinched nerves from a herniated disc, or spinal slippage or abnormal curvature. Electroencephalogram (ECG) may be used to monitor for any evidence of seizures that could explain any muscle spasms, blackouts, or memory deficits.

Treating Tension Headaches and Neck Pain

Some of the most effective treatments for tension headaches and neck pain include techniques that concentrate on relaxation, usually with biofeedback of some kind to help educate patients as to how to help themselves relax if they feel tense. Record-keeping is important in monitoring the impact of treatments and also to help physicians obtain a clearer view of the impact tension headaches and neck pain are having on quality of life. Daily records may also reveal triggers such as environmental hazards or foods that could be avoided. Even simple things such as how long you slept or whether you took the car or the bus to work can make a difference when a pattern is revealed. A minority of patients even find that their shoes cause their tension headaches and neck pain as they subtly change the spinal alignment and cause muscles to become overworked.

Swallowing handfuls of analgesics for tension headaches and neck pain may get your through today but this simply defers the problem and could even exacerbate it. Putting in a little work with your physician to try to identify your head and neck pain triggers could allow you to be free of tension headaches and neck pain, and all the stress they themselves can cause.

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