Tension-Type Headaches: Breaking the Cycle of Pain with Osteopathy
That familiar feeling of a tight band around your head or a constant pressure at your temples is more than just an annoyance—it's likely a tension-type headache (TTH). As the most common type of primary headache, TTH can significantly impact daily life, work, and wellbeing. Unlike migraines, they are typically not associated with nausea or light sensitivity, but they can be just as persistent and debilitating.
Osteopathy offers a drug-free, holistic approach to managing tension-type headaches by addressing the musculoskeletal drivers that often contribute to their onset and persistence.
Key Facts About Tension-Type Headaches
The Most Prevalent Headache: Tension-type headaches affect up to 80% of the population at some point in their lives, with chronic forms impacting about 3% of adults.
A Primary Headache Disorder: TTH is classified as a primary headache, meaning the headache itself is the condition, not a symptom of another disease.
Spectrum of Frequency: They can be episodic (occurring less than 15 days per month) or chronic (15 or more days per month for over 3 months).
Common Causes and Triggers
While the exact cause is multifactorial, TTH is strongly linked to heightened muscle tension and stress. Key triggers and contributing factors include:
Musculoskeletal Dysfunction: This is a primary focus for osteopaths. Dysfunction in the upper cervical spine (neck) and the muscles of the head, neck, and shoulders is a major contributor. This includes:
Joint stiffness in the neck (particularly C0-C3).
Hypertonicity (excessive tightness) in the suboccipital muscles at the base of the skull, trapezius, and sternocleidomastoid muscles.
Trigger points in the shoulder and neck muscles that refer pain to the head.
Postural Strain: Prolonged poor posture, such as "tech neck" from computer use or awkward positions at work, places sustained stress on the muscles and joints that can trigger headaches.
Stress and Anxiety: Emotional and psychological stress is a well-established trigger, leading to involuntary muscle contraction and nervous system arousal.
Jaw Clenching (Bruxism): Overnight or daytime clenching places strain on the temporalis and masseter muscles, which can refer pain to the temples and forehead.
Dehydration, Eye Strain, and Fatigue: Common lifestyle factors that can lower the headache threshold.
Common Signs and Symptoms
Pain Quality: A constant, dull, pressing, or tightening sensation—often described as a tight band or vice around the head.
Pain Location: Typically bilateral (affecting both sides), commonly felt in the forehead, temples, or back of the head and neck.
Mild to Moderate Intensity: Usually not severe enough to prevent daily activities, but can be persistent.
No Associated Neurological Symptoms: Unlike migraines, there is typically no nausea, vomiting, or sensitivity to light and sound (photophobia and phonophobia). Physical activity does not usually worsen the pain.
Muscle Tenderness: Palpation of the neck and scalp muscles often reveals tight, tender spots.
How Can Osteopathy Help with Tension-Type Headaches?
Osteopathic treatment for TTH is centered on a thorough assessment to identify and treat the specific musculoskeletal dysfunctions that are contributing to your headache pattern.
During your initial consultation, we will:
Take a detailed history of your headache pattern, triggers, lifestyle, and any history of neck injury.
Perform a physical examination with a focus on your posture, and the mobility of your cervical and thoracic spine.
Palpate for areas of joint restriction, muscle hypertonicity, and fascial tension in your neck, shoulders, and jaw.
What Does Osteopathic Treatment Involve?
Using gentle, hands-on techniques, we aim to:
Reduce Cervical Spine Tension: Gentle articulation and mobilisation of the upper cervical joints (C0-C3) and the rest of the neck can relieve joint stiffness that may be contributing to nerve irritation and pain referral.
Release Muscle Hypertonicity and Trigger Points: Soft tissue massage, myofascial release, and stretching are used to relax the overactive suboccipital, trapezius, and pericranial muscles, alleviating the direct source of tension.
Address Postural Drivers: Treatment often extends to the upper back (thoracic spine) and ribs to improve overall posture, reducing the forward head position that strains neck muscles.
Improve Fascial Glide: Techniques to release restrictions in the connective tissue (fascia) of the scalp, neck, and shoulders, which can contribute to a feeling of tightness.
Provide Personalised Advice and Self-Management Strategies: You will receive guidance on:
Ergonomics and Postural Awareness: For your workstation and daily activities.
Stress Management Techniques: Such as breathing exercises.
Targeted Stretches and Exercises: For the neck and shoulders to maintain mobility and strength between treatments.
Lifestyle Modifications: Addressing hydration, sleep, and regular movement breaks.
When to Seek Medical Help
It is essential to obtain a correct diagnosis for your headaches. Please consult your GP for an initial diagnosis to rule out other types of headache or underlying conditions. Seek urgent medical attention if you experience a headache that is:
Sudden, severe, and unlike any you've had before ("thunderclap headache").
Accompanied by fever, stiff neck, confusion, seizures, double vision, or weakness/numbness.
Worsens progressively over days or hours.
Begins after a head injury.
Your GP can help establish a management plan and determine if your headaches are truly tension-type or require further investigation.
Find Lasting Relief from Headache Pain
If you are caught in a cycle of tension and headache pain, osteopathy can offer a direct, hands-on approach to break that cycle. By treating the physical root causes in your neck and posture, we can help you achieve significant and lasting relief.
Click here to schedule an appointment with one of our experienced osteopaths. Let us help you find a clearer path forward, free from headache pain.
References
*Bendtsen, L., et al. (2021). Guideline on the use of onabotulinumtoxinA in chronic migraine: a consensus statement from the European Headache Federation. The Journal of Headache and Pain, 22, 42. [Link: https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-021-01253-3] (Note: While on botox, this guideline discusses mechanisms and includes TTH context).
*Luedtke, K., Allers, A., Schulte, L. H., & May, A. (2016). Efficacy of manual therapy interventions for the management of migraine and tension-type headache: A systematic review and meta-analysis. Headache: The Journal of Head and Face Pain, 56(4), 674-700. [Link: https://headachejournal.onlinelibrary.wiley.com/doi/abs/10.1111/head.12765]*
*Headache Australia. (2023). Tension-Type Headache. [Link: https://headacheaustralia.org.au/types-of-headaches/tension-type/]*
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Osteopaths are primary healthcare practitioners who can assess and treat musculoskeletal components of headache. Always consult a registered health practitioner, such as your General Practitioner (GP) or neurologist, for the diagnosis and medical management of headache disorders. Osteopathic care is a complementary approach and should be integrated with your overall healthcare plan. Individual results from osteopathic treatment may vary. The information provided is based on the best available evidence at the time of publication.