Tension-type headache – prevention through knowledge

Our bodies have the capacity to adjust our pain threshold to different situations. This is carried out by the pain regulation system (explained below: 'How tension-type headache develops'). Tension-type headaches happen when the body's pain regulation system is overstretched. Essentially, this means that anything that puts extra strain on the system can trigger a headache. This might happen if we are overworked, overwhelmed, sitting or standing in one position for long periods, or putting too much strain on certain parts of the body. Other potential triggers include:

  • Stress, anxiety and depression
  • TMJ (temporomandibular joint) disorders – grinding your teeth, clenching your jaw, restricted jaw movement
  • A poorly lit or noisy workplace
  • Not getting enough restful sleep

Where should I start?

To avoid tension-type headache, you need to regularly give your body's pain regulation system a chance to recover. You should also try to minimise factors that put particular strain on the system.

'Take breaks + minimise stress' is a great rule for preventing tension-type headaches. The right mix of concentration and relaxation, regular breaks, restful sleep and pleasant working conditions will protect your pain regulation system and keep your brain working effectively.

Sticking to a few simple rules in these lifestyle areas can do wonders for your brain:

  • Workplace

    Combating stress in your working day

    • Aim for a healthy posture at work
    • Interrupt your working posture often, move around and take deep breaths
    • Have regular short breaks
    • Also plan longer breaks of at least 30 minutes
    • Screen-free time: at least 3 long breaks

    Workplace

    How you arrange your working day and set up your workplace is key to headache prevention. Again, 'take breaks + minimise stress' applies here.

    Poor posture at work puts a lot of strain on your muscles and joints. This is very demanding for your pain regulation system, and that can lead to a headache. A few changes to your workspace layout can help you get through the day without a headache.

    Frequent breaks are also key to a healthy brain. You should regularly interrupt your posture to offset the strenuous effects of work.

    Working posture

    Try your best to maintain a healthy posture at work. Set up your workstation so that you can work comfortably. If you work at a computer, sit up straight with your shoulders relaxed. Avoid slouching or hunching over. Your neck and shoulders should always be relaxed.

    If you often repeat the same movements at work, and are therefore straining certain parts of the body, it is important to take plenty of breaks where these movements are interrupted. Try to balance things out by moving differently at regular intervals. Sitting in the same position for a long time at work also puts a tremendous strain on your body. Use your breaks to move around and combat the effects of prolonged sitting.

    Breaks

    Working without a break increases your risk of a headache attack. Your pain regulation system allows you to stay focused on your work but, if it becomes overstretched, you may be setting yourself up for a headache. Give your pain regulation system a chance to recover. Incorporate frequent short breaks (2-3 minutes) into your working day, and schedule longer breaks of at least 30 minutes.

    Use your breaks to interrupt your posture. Move around to offset the effects of prolonged sitting or unhealthy postures that particularly strain certain parts of your body. Stretch out your body or get rid of the tension in your muscles by shaking them out.

    Have a big yawn and relax by focusing only on your breathing for a moment. Close your eyes and take a few deep breaths in and out. Open a window if you can. You could also get yourself a drink or eat an apple. The main thing is to consciously interrupt your workflow and take a moment for yourself.

    Set reminders for yourself – a notification from your phone or another recurring sound/event may be useful. The 'Prevent Headache' app has a reminder feature for regular breaks.

    Screen-free time is essential

    Staring at a screen is particularly demanding for the eyes and the brain. If you spend a lot of time working with screens, frequent breaks are essential to allow them to recover. These moments should be completely screen-free – no phone, tablet, computer or TV. You need 3 screen-free breaks of at least 30 minutes each day. If your work involving screens is particularly tiring, you should take longer.´

    Listen to your body

    Pay attention to the cues your body is giving you. Neck pain can be a sign that you've been sitting still for too long and need another break. Strenuous movements can lead to noticeable tension in your muscles and joints.

    Learning to recognise your body's warning signals can help you to react in time to prevent a headache. Take a short break right now if you can. Make a point of using the next (scheduled) break to interrupt your workflow and take a moment for yourself.

  • Relaxation

    Conscious relaxation helps balance the nervous system

    • Set aside time for relaxation in your weekly schedule
    • Tip: learn relaxation techniques

    Relaxation

    Conscious relaxation on a regular basis is a great way to prevent tension-type headaches. You should incorporate dedicated relaxation periods into your weekly routine. Regular relaxation helps to calm your nervous system, which is a very important way to prevent tension-type headaches.

    Learn relaxation techniques

    Research studies have demonstrated the effectiveness of certain relaxation techniques. Jacobson's progressive muscle relaxation has proven particularly successful. It's easy to learn and, with practice, you can do it almost anywhere. Use the step-by-step guide in the 'Prevent Headache' app or access it in the 'Resources' part of this website.

  • Physical activity

    Exercise helps to balance your nervous system

    • Integrate movement into your day: walk or cycle more if you can
    • Exercising in the fresh air is an ideal way to recharge your batteries
    • Rule of thumb: half an hour of active exercise 3 to 4 times a week

    Physical activity

    Exercising is a tried and trusted way to prevent headaches. The right mix of concentration and relaxation helps to balance your nervous system and keep your levels of stress hormones down.

    Daily exercise

    Exercising in the fresh air is an effective way to beat tension-type headaches. Half an hour a day should be enough. Walking or cycling to get around is good for your brain as well as your body. Half an hour of active exercise 3 to 4 times a week is also recommended, though you should not overexert yourself.

    Regular, healthy exercise such as swimming, cycling or hiking is good for you and helps you and your brain to relax. However, don’t overdo it. Find a sport that makes you feel good.

  • Sleep

    Sleep refreshes the brain

    • Take time to wind down before going to bed
    • Find out how much sleep you need – and stick to it
    • Stick to your sleep schedule on weekends
    • Rule of thumb: 7–9 hours

    Sleep

    Your body rests and recharges while you sleep. That's why getting enough restful sleep is essential for a healthy brain. Find out what you need for a restful night's sleep. Wind down for half an hour before going to bed. Turn off your phone and get some me-time. Find a bedtime ritual you like and that works for you. Allow your body and mind to wind down.

    Sleep duration

    How much sleep do you need to feel refreshed in the morning? 7– 9 hours is a good rule of thumb. Once you've figured out your ideal bedtime, try to stick to it every night – even on weekends.

  • Nutrition

    Regular meals, mindful eating

    • Your brain needs carbohydrates to work in a healthy way
    • Schedule regular breaks for meals and enjoy your food without distraction
    • Take time for breakfast
    • 3 main meals, 2 snacks

    Nutrition

    Eat regular meals and practise mindful eating. The brain is one of the body’s hungriest organs. It needs a constant flow of energy to work properly. That's why regular meals are important to prevent headaches. It’s best to have 3 meals spread out over the day and 2 snacks containing plenty of carbohydrates. Cereals like bread, pasta and rice – preferably whole grain – legumes and potatoes contain carbohydrates.

    Eat regular meals and take your time

    Build regular breaks into your workday for an unrushed meal. Mindful eating helps us to eat right. Chew your food slowly and thoroughly. Taste and savour every bite. It’s good for your digestion and helps you to stop eating when you’re full. Your brain gets the energy it needs and you get a little break from your workday.

    Breakfast

    Breakfast is important for a healthy brain. Your energy stores are empty in the morning after not eating all night. Spend at least 30 minutes eating a proper breakfast. A hot breakfast containing complex carbohydrates (muesli with hot milk, for instance) gives your nervous system lots of energy. Other whole foods such as wholegrain bread are also very good at filling up your energy stores.

  • Hydration

    Your brain needs water

    • Rule of thumb: 2–3 litres of fluids per day
    • Drink regularly: Start your day by drinking plenty in the morning, then at least every 2 hours afterwards.
    • Water is best. Avoid sugary drinks and alcohol.

    Hydration

    Your body needs fluids to be able to perform all the functions that keep you alive. If you don't drink enough, your blood will not be able to transport nutrients to your brain. Your brain will not get the energy it so badly needs.

    Drink regularly

    Drinking regularly is important. Be sure to drink enough first thing in the morning and have something to drink at least every 2 hours afterwards.

    How much is enough?

    Drink 2–3 litres of fluids every day. If you do a workout, you will need even more. Water and other unsweetened beverages are best. Enjoy coffee, black tea and alcoholic beverages in moderation. If your work does not provide drinks, carry drinks from home.

Discover your headache type

Migraine, tension-type headache and medication-overuse headache are by far the most common types of headache. Take the Quick Headache Quiz to discover if your headache is one of these three types.

TAKE THE QUIZ

Understanding tension-type headacheUnderstanding tension-type headache

Tension-type headache is the most common type of headache. It affects one in two headache sufferers.

  • How tension-type headache develops

    How tension-type headache develops

    The current scientific understanding is that tension-type headache is the result of the body's pain regulation system becoming exhausted. But how does the pain regulation system work and how is it connected to headaches?

    Our body is able to adjust its pain sensitivity to different situations. The brain is constantly regulating how much pain information to let through. If the body is exposed to prolonged stress, such as when we are concentrating on something important, the brain lowers our pain sensitivity. This means that it lets through less pain information, allowing us to concentrate without interruptions.

    However, our brain's ability to regulate pain in this way is limited. If it is under strain for too long, the pain regulation system becomes exhausted. The brain can now no longer sufficiently regulate the pain, meaning that pain signals can flow in unhindered, causing a headache.

    How does a tension-type headache feel?

    Almost everybody has experienced tension-type headache. Perhaps you have been focused on work for hours, not moving from your desk, and continuing to work even though you are already tired and may be experiencing neck pain. Ultimately, you also end up getting a headache.

    Tension-type headaches typically feel like a pressing or squeezing pain – like a tight helmet pressing on your head or a weight pushing down. They often start at the nape of the neck and spread across the back of the head to the forehead and eyes. Nausea and sensitivity to light and noise are generally not present. Physical activity also does not worsen the pain. On the contrary, exercising in the fresh air can quickly improve the pain.

Properties of tension-type headache

Duration
  • 30 minutes to 7 days (if untreated)
Accompanying symptoms
  • No nausea
  • Sensitivity to light or noise is not usually present
Headache properties
  • Pressing or squeezing pain on both sides of the head
  • Mild to moderate pain
  • Physical activity does not make it worse
    (such as walking or climbing stairs)

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