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Tension headaches
Symptoms of a tension headache

Common symptoms of tension headaches include:

  • pain on both sides of your head, face or neck
  • feeling like something is pressing on your head or being tightened around it
  • the affected area may feel tender and your head may hurt more when touched

You should be able to continue doing daily activities without making the headache worse.

Tension headaches last at least 30 minutes but they can last much longer, sometimes for several days.

Causes of tension headaches

Common causes of tension headaches include:

  • stress
  • sleep problems
  • caffeine

Taking painkillers for headaches too often or for a long time can also cause headaches. These are known as overuse or rebound headaches.

Tension headaches are not a sign of an underlying condition.

How to ease a tension headache

There are some things you can do to treat a tension headache yourself.

Do

  • use painkillers like paracetamol, aspirin and ibuprofen – paracetamol is the first choice of painkiller if you're pregnant, and children under 16 should not take aspirin

  • try doing activities to help you relax like exercise, yoga and massage

  • try changing your sleeping habits if sleep problems like insomnia may be causing your headaches

  • try using a low, firm pillow and heat or cold packs if you have neck pain and headaches

Don't

  • do not have drinks with caffeine in them like tea, coffee or cola - or try to cut down on them

A pharmacist can help with headaches

You can ask a pharmacist about:

  • the best painkiller to take, if you're not sure which is suitable for you
  • what to do if you're pregnant – some medicines (like ibuprofen) are not recommended in pregnancy
  • medicines for sleep problems like insomnia if you're having trouble sleeping and you think it may be causing your headaches

See a GP if:

  • you get headaches several times a week or they're severe
  • painkillers and activities to help you relax do not help your headaches
  • you have a throbbing pain at the front, or on 1 side of, your head
  • you feel sick, vomit and find light or noise painful

These can be signs of a different type of headache, such as a migraine or cluster headache.

Get an urgent GP appointment or call 111 if:

You or your child have a severe headache and:

  • jaw pain when eating
  • blurred or double vision
  • a sore scalp
  • other symptoms, such as numbness or weakness in the arms or legs

Also get an urgent GP appointment or call 111 if your child is under 12 years old and has any of the following:

  • a headache that wakes them at night
  • a headache when they wake up in the morning
  • a headache that gets progressively worse
  • a headache triggered or made worse by coughing, sneezing or bending down
  • a headache with vomiting
  • a headache with a squint (where the eyes point in different directions) or an inability to look upward

You can call 111 or get help from 111 online.

Call 999 or go to A&E if you or your child:

  • have a head injury – for example, from a fall or accident
  • have a headache that came on suddenly and is extremely painful

You or your child have an extremely painful headache and:

  • sudden problems speaking or remembering things
  • loss of vision
  • feel drowsy or confused
  • a very high temperature and symptoms of meningitis
  • the white part of the eye is red

Also call 999 or go to A&E if your child is under 12 years old and has any of the following:

  • a headache with vision problems or difficulty speaking, swallowing, balancing or walking
  • a headache with drowsiness or a persistent lack of energy
  • a headache that starts within 5 days of a head injury
What happens at your GP appointment

If you have regular tension headaches, a GP may suggest you keep a headache diary to record details of your headaches like:

  • how often you get them and how long they last
  • how painful they are and any other symptoms you have
  • possible causes
  • any medicines you take to help

The GP may advise you about taking painkillers for tension headaches, such as when to take medicine and how often you should take it.

You may be referred to a specialist if painkillers and activities like exercise do not help reduce your headaches or if it's not clear what's causing them.

Preventing tension headaches

An antidepressant medicine called amitriptyline is sometimes recommended to help prevent tension headaches.

You'll be prescribed a low-dose to start with, which may be increased later. You usually need to take the medicine for several months before it starts working.

Last Reviewed
08 August 2025
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Superintendent Pharmacist: John Archer  (2076659).
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