Headaches are overwhelmingly more common in women, with a male-female ratio of 1:4. Migraines and tension headaches are particularly common in women. “Even though it’s called a migraine, nearly 40% of people experience headaches on both sides. Some people also experience pain in the back of the head or the entire head. Most of the time, the pain is throbbing, but sometimes it feels like the head is being squeezed. To distinguish it from other headaches, if the pain increases when you shake your head or move your body, it’s likely to be a migraine,”
If You Have a Tension headache, moving your body won’t make it worse!
Among chronic headaches, migraines are characterized by sudden, unilateral, throbbing, pulsating pain that lasts for 4 to 72 hours.
What is a tension headache, which is said to be the second most common headache after migraine?
Severe stiffness in the shoulders and neck, together with a headache, are the usual symptoms of tension headaches, which usually worsen in the afternoon and evening. Dizziness, weariness all around, and eye strain may also accompany them.
A characteristic of tension headaches is that the pain does not get worse when you move your body, and you do not experience nausea. If the pain is relieved by stretching, you likely have tension headaches.
Tension headaches are caused by tension in the muscles of the shoulders, neck, and sides of the head due to stress, which reduces blood flow and causes waste products such as lactic acid and pyruvic acid to accumulate in the muscles, stimulating the nerves. The characteristic symptom is a dull pain that feels like the head is being squeezed.
If you experience the following pain, you may have a tension headache:
[Tension-type headache]
- Pain that feels like a squeezing sensation
- Pain located on both sides or at the back of the head
- A sense of pressure, heaviness, or dull pain in the head
- Can occur daily or occasionally
- Often occurs in the evening
- Symptoms do not worsen with exercise
- Mild to moderate pain with minimal impact on daily life
- Pain may ease with a bath or alcohol consumption
- Stiffness in the shoulders or neck
Migraines and tension headaches share common triggering factors, such as stress, fatigue, and sleep disorders caused by lack of sleep or excessive sleep. Thus, many people suffer from both types of headaches.
There are two ways in which symptoms of the combined type manifest.
- Type that experiences migraines and tension-type headaches on some days.
- Type that experiences tension-type headaches daily and migraines occasionally.
If you suspect you may have the combined type, it is recommended that you see a headache specialist, as it may be difficult to treat it appropriately on your own.
Measures and treatments for tension headaches
Tension headaches can be caused by chronic shoulder stiffness or by sitting in the same position for long periods, which causes tension in the muscles of the neck, shoulders, and side of the head, resulting in poor blood flow. Mental stress can also cause blood vessels to tense up and constrict, resulting in poor blood flow and headaches.
“When that happens, try lightly stretching your neck and shoulders. You can also raise and lower your shoulders, or clasp your hands together and place them behind your head, then use the weight of your hands to slowly tilt your neck forward.
People often wonder whether it is okay to take headache medicine, but since most people with tension headaches have mild symptoms, it is not uncommon for the headache to be cured by taking an over-the-counter headache medicine (painkiller) once. In such cases, it is considered okay to take the medicine.
Be careful not to take too much headache medication, as this can lead to a “medication overuse headache.” If your headache does not go away without repeatedly taking medication, it is likely not a tension headache. It could be a migraine or a secondary headache caused by another issue. Secondary headaches can sometimes affect your health prognosis.
If you visit a hospital and are diagnosed with a tension-type headache, you will be treated with medication to relieve the headache during the acute phase of the headache. It is said that these medications often lead to the prevention of tension-type headaches.
But, even in this case, if you continue to use it for more than three months, be sure to be careful about the usage and dosage to avoid developing a headache due to medication overuse (medication overuse headache)
[Medications commonly used for tension-type headaches]
- Analgesics (headache medicine) and nonsteroidal anti-inflammatory drugs (NSAIDs)
- Caffeine: has the effect of relieving pain
- Antidepressants: have the effect of raising the pain threshold, making it harder to feel pain, especially in chronic tension headaches
- Anti-anxiety drugs: have the effect of relieving tense feelings
- Muscle relaxants: have the effect of relieving muscle tension
- Botulinum toxin: used when other medications cannot control the pain
Migraines and tension headaches: what to be careful of in daily life
“There are some differences between migraines and tension headaches in what you should and shouldn’t do in your daily life. One thing they have in common is that people who suffer from chronic headaches should avoid any actions that stimulate the brain in their daily lives, so as not to excite the brain as much as possible.
[Migraine Measures]
- Live a regular life. Sleep for the same amount of time even on holidays.
- Try to eat breakfast.
- Eat mostly Japanese food.
- Consume caffeine and sugar in moderation.
- Always carry a hat and sunglasses to avoid strong light.
- Avoid strong scents such as perfume and air fresheners.
- Do not consume too much chocolate or alcohol such as red wine.
Migraines are caused by the expansion of blood vessels in the brain, which stimulates the trigeminal nerve around the blood vessels, causing pain. The pain can be relieved by cooling the painful area and constricting the expanded blood vessels. When you have a migraine, it is important to avoid long soaks in a bathtub, which promotes blood flow, and to only take lukewarm showers.
For people with migraines, strong light, strong smells, and loud noises can easily stimulate the brain, so try to relax with moderate, comfortable lighting, music, and scents.
When blood sugar levels drop due to hunger, the blood vessels in the brain relax, stimulating the surrounding trigeminal nerves and making you more susceptible to migraines. Try not to get too hungry and keep your blood sugar levels constant.
Eating too much chocolate, red wine, or citrus fruits, which contain vasodilators such as tyramine and polyphenols, can make you more susceptible to migraines, so be careful not to eat large amounts or consume them in many doses.
If you feel the onset of a headache, drinking coffee or tea will help flush water from your body and restore the dilated blood vessels in your brain.
Foods that can be expected to prevent migraines are those that are rich in magnesium, vitamin B2, calcium, and dietary fiber, which have the effect of stabilizing cerebral blood vessels and brain nerve cells. For example, wakame seaweed, burdock, eggs, and mushrooms are foods that help prevent headaches.
Be careful with these habits, as they can lead to migraines
- Often going to crowded places… Crowds are subject to strong physical stimuli such as sound, light, and scent, making them more susceptible to motion sickness. Also, in enclosed spaces, the oxygen levels become thin, causing the blood vessels in the brain to dilate.
- Wearing a ponytail: Pulling on the scalp can stimulate the occipital and trigeminal nerves, and this information can secondarily be transmitted to the brain, triggering or worsening a migraine.
- Sleeping too much on the weekends…Not only insomnia but also sleeping too much causes the parasympathetic nervous system to become dominant, making the cerebral blood vessels more likely to relax, and eating breakfast too late can also cause a drop in blood sugar levels, leading to migraines.
- Sleeping with the lights on… Fluorescent light stimulates an oversensitive brain.
- Not eating breakfast or being on a diet… Hunger can lead to hypoglycemia, which relaxes the blood vessels in the brain and stimulates the trigeminal nerve around the blood vessels, causing migraines and making you more irritable.
[Measures to prevent tension headaches]
- Relax your neck and shoulder muscles by stretching or taking a bath.
- Don’t let stress or fatigue build up too much, and relieve it appropriately.
- Avoid maintaining the same posture for long periods, such as sitting or standing.
Tension headaches occur when muscles tense up due to stiffness or stress, constricting the blood vessels in the muscles and reducing blood flow. While the pain of a migraine can be exacerbated by applying heat, tension headaches can be prevented or improved by applying heat to promote blood flow.
As you can see, there are many things you can do in your daily life to prevent headaches. Also receiving treatment at the hospital, and self-care can help improve and prevent chronic headaches such as migraines and tension headaches.
Reference material / Japanese Headache Society “To the public and patients”
The person we spoke to was… Professor Toshihiko Shimizu
Tokyo Women’s Medical University Council Member Visiting Professor, Department of Neurosurgery, Headache Clinic
Doctor of Medicine. Specialist of the Japan Neurosurgical Society. Specialist of the Japanese Headache Society. Full member of the American Headache Society. A leading expert in headache treatment, he sees an average of 200 patients daily at Shiodome City Center Central Clinic Headache Clinic and many other hospitals. His books include “Headaches Disappear” (Diamond Inc.), his latest book “Ultra Illustrated Headaches for Adults and Children” (Hoken), and many others.
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