Mississauga Chiropractor Presents: Tension Headaches

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Here’s another blog from a Mississauga Chiropractor…

A Tension Headache consists of an intermittent headache; “feels like my head is in a vise” or “a band of pain around my head like a head band” associated with muscular origin, trigger point & other myofascial pain syndromes.  The pain should be even, and not throbbing.  There should be no nausea, no photophobia and no phonophobia.


Episodic Tension-Type Headache:

  • Less than 15 headache days per month.  The duration of the headache is 30 minutes to 7 days
  • At least two of the following:
    • Bilateral location
    • Pressing/tight (non-pulsating) quality
    • Mild or moderate activity modification due to the headache (not severe or incapacitating)
    • No aggravation by walking stairs or routine physical activity
  • Both of the following:
    • No nausea or vomiting & no photophobia or phonophobia


Chronic Tension-Type Headache:

  • Same criteria as above (episodic headache) except at least 15 headache days per month for 6 months.



  • Gender:  Affects females > males
  • Age: more common in young adults (60% of headache onset occurs in those older than 20 years), rare onset in patients over 50 years old.


Potential Risk Factors:

  • General stress, lack of rest or sleep
  • Muscular stress, prior neck injuries, postural imbalances, TMJ syndrome
  • Psychiatric factors, depression, social factors



  • Pain location is bilateral & located occipitonuchal or bifrontal
  • Pain quality:  described as “tightness/squeezing”, “pressure”, “bandlike/viselike”
  • Duration of 30 minutes to 7 days
  • Minimum of 10 previous headache episodes; fewer than 180 days per year with headache
  • May occur acutely under emotional distress, difficulty concentrating
  • Insomnia; Headache often present upon waking up in the morning
  • Not aggravated by physical activity
  • Muscular tightness or stiffness in the neck, occipital & frontal regions
  • Duration of more than 5 years in 75% of patients with chronic headaches
  • No nausea, vomiting, photophobia, phonophobia or auras



  • Massage therapy is extremely effective
    • Myofacial trigger point techniques (upper trapezius, splenius, suboccipitals & SCM)
    • Stretching and relaxation therapy
  •  Cervical adjustments to the upper cervical spine and occiput
  • Stress management & relaxation therapy
  • Postural and ergonomic evaluation
  • Stretching and self massage are often of benefit



  • Tension headaches are usually chronic if life stressors are not changed; most cases are intermittent and do not interfere with work or normal life span.


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