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By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Tension headache is very common.

Every third child who goes to school complains about frequent repeated headache. Headache is only rarely seen with children less than 5 years old. Especially tension headache is common and it is estimated that around half of all school children have experienced tension headache. Migraine is more rare but 10% will have had one or several migraine attacks before puberty.

Many with tension headache relate that the headache is triggered by certain conditions. It can be stressful situations or strain of the muscles of the neck and shoulders, for example from monotonous work. Other explanations of tension headache can be bad eyesight, misaligned bite or osteoarthritis in the spine.

In the situations mentioned, the muscles of neck, shoulders and face tense up. Thereby causing an overload of the muscles that is experienced as tension headache. This is why it is called tension headache. The same thing happens when you begin hard physical work or exercise after a longer break. It also causes pain to the muscles you have used.

Usually, tension headache is light to medium in pain. The headache lasts from few hours all the way up to 7 days. It is experiences as oppressive or tightening in everywhere in the head. Often, there are sore points in the neck or by the temples. There is no worsening when you are physically active like walking on stairs and no nausea and vomiting. This is how tension headache is different from attacks of migraine.

Often, migraine is located in the forehead or one or both of the temples. The pain comes in attacks and is described as strong and throbbing or hammering. The pain is worsened when you move and therefore most prefer to lie completely still. Most often, the headache lasts 1 to 6 hours but can last up to 48 hours. Loss of appetite, nausea, vomiting and sensitivity towards light and sound is common. Therefore, the ill person prefers to stay in a room without light and noise. A migraine attack can be triggered by tension, problems, anxiety, hunger and too little sleep. Typically, parents or siblings also have migraines.

Brain tumours can cause headache but it is an extremely rare cause of headache. Often, the ill person will then wake up with a very strong headache, a lot of vomiting and trouble with moving around normally.

Another common cause of headache is infections that cause fever. Most infections (influenza, common cold etc.) cause headache.

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Most people with tension headache can make do with ordinary painkilling medication (e.g. paracetamol or ibuprofen) that can be bought over the counter. A few people take painkilling medication on a daily basis. This is not a good idea. It is a known fact that a daily consumption as such can cause headache on its own. If you stop after a longer period of daily use, it triggers a severe headache and the only thing that soothes is another dose of medication. This way, you become addicted to the medication – even though it is ‘just’ ordinary painkilling medication bought over the counter.

What can you do?

Massage can soothe the pains. Painkilling medication. Medication for migraine (on prescription).

Contact the doctor tomorrow

If you for more than 1 week have had a daily consumption of painkilling medication. Also even though it is ‘just’ ordinary painkilling medication that can be bought over the counter.

Contact the doctor immediately

If the headache does not diminish, in spite of you own treatment. If the ill person is not clear in the head, speaks incoherently or cannot use arms and legs normally.