Tension Type Headaches

Tension-type headaches (TTH) can be identified as either episodic or chronic. It is usually described as having a tight, vice-like band around the head. The headache is not particularly painful, ranging from mild to moderate pain; and while not debilitating, some light and/or noise sensitivity may occur (Chowdhury, D, 2012).

Who Is Affected?

TTH is the most common headache disorder, internationally affecting 32% of men and 42% of women. This suggests that approximately seven million Australians are likely to have TTH.

The onset of TTH is usually in the age range of 20-30, but data from a Sydney Clinic shows that around 15% of people who came in with a TTH were under the age of 10 and over the age of 50 (Headache Australia, 2018).

Types of Tension-Type Headaches

In terms of the classification of TTH, it can be put into three subtypes (Bendtsen, L, 2009):

  • Infrequent Episodic TTH - Headache with a frequency of 1 day or less per month

  • Frequent Episodic TTH - Headache with a frequency of 1-14 days per month

  • Chronic TTH - Headache with a frequency of 15 days or more per month


Some of the symptoms of TTH include (Headache Australia, 2018):

  • Dull and persistent pain on both sides of the head (bilateral)

  • Vice-like, pressing pain that goes on or around the head

  • Decreased range of neck movements

  • Photophobia (Sensitivity to Light)


  • Phonophobia (Sensitivity to Sound)

  • Trouble concentrating or difficulty sleeping

  • Nausea and Indigestion

Despite being dubbed Tension-Type Headache, there are a few triggers outside of muscular tension, such as:

  • Psychological Stress

  • Mental Exhaustion and Fatigue

  • Medication Overuse

  • Bright lights or Loud Noises

  • Poor Posture

  • Depression

  • Insomnia and Disturbed Sleep


In the pharmacological approach, simple analgesics such as ibuprofen has seen an effective response from TTH sufferers when taken at early onset of an attack and at an adequate dose.

If the attacks increase in intensity and frequency, stronger analgesics has its limitations, as it has a chance to turn an episodic TTH into a chronic TTH. This is due to medicine overuse, which can have the opposite intended effect and actually make the TTH worse (BMJ Best Practice, 2018).

From a physical therapy approach, Falsiroli Maistrello et al., (2018) has found that manual trigger point therapy, specifically applied around the head and neck can reduce the intensity, frequency, and duration of a TTH attack. Correction of posture (work, home, or driving) and a home exercise program also has merit (Chowdhury, D, 2012).

Lastly, psychological stress and mental wellbeing are big factors to TTH, and so, decreasing stress and some relaxation training can help.

What Richmond Rehab Can Do For You

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Trigger point therapy, correction of posture, and a home exercise plan have shown to have positive results in the treatment of tension-type headaches. Our practitioner Julius Principe has a keen interest in treating headaches and migraines. Utilising a multidisciplinary approach, Julius can work collaboratively with your current health care professional to help you manage your symptoms.