Tension Type Headache (TTH) Causes

The exact cause or causes of tension headache are unknown. Experts used to think that the pain of tension headache stemmed from muscle contraction in the face, neck and scalp, perhaps as a result of heightened emotions, tension or stress. But research suggests that there doesn't appear to be a significant increase in muscle tension in people diagnosed with tension headache.

Researchers now suspect that tension headache may result from changes among certain brain chemicals — serotonin, endorphins and numerous other chemicals — that help nerves communicate. Although it's not clear why the chemical levels fluctuate, the process is thought to activate pain pathways to the brain and to interfere with the brain's ability to suppress the pain.

The exact causes of tension-type headache (TTH) are not clearly understood, but certain factors may trigger them.

Tension Type Headache (TTH) Triggers

 These include:

• Anxiety, stress and depression.
   
• Changes in your daily routine such as not getting enough sleep or a change in diet.
   
• Alcohol, caffeine or smoking.
   
• Muscle tension or tightness in the head and neck.
   
• Overuse of pain medication. Some chronic daily headaches may actually be rebound headaches caused by medication over-use.
   
• Poor posture when doing things like working long hours on your computer or lifting heavy objects incorrectly. Also, holding your head in one position for a long time such as sleeping with your head at an odd angle.
• Stress
• Depression and anxiety
• Poor posture
• Working in awkward positions or holding one position for a long time
• Jaw clenching

Tension Type Headache (TTH) Types

According to the International Headache Society (IHS), there are three distinct types of TTH. 

• Headaches that occur less than once per month – Each headache episode can last from 30 minutes to seven days. These headaches have little impact on your life. They can usually be treated with over-the-counter (OTC) pain-relievers or no treatment at all. These are also called “infrequent episodic tension-type headaches.”

• Headaches that occur on one to 14 days per month for at least three months – Each headache episode can last from 30 minutes to seven days. They can be treated with OTC pain-relievers, but they often increase over time and become chronic headaches. If your headaches become consistently worse, more frequent and/or interfere with your life, visit a health care provider. These are also called “frequent episodic tension-type headaches.” 

• Headaches that occur on 15 or more days per month for at least three months – These headaches can come or go, or they may be continuous. For example, your headache may be mild but never completely goes away. These headaches should be diagnosed and treated by a health care provider, as they can greatly decrease your ability to work and enjoy life. These are also called “chronic daily headaches” or “chronic tension-type headaches."