Tension headaches: causes, relief and when to see a doctor
Why tension-type headaches happen, how they differ from migraine and neck-related headaches, what often helps, and the warning signs that need medical advice.
Tension-type headache is the most common kind of headache. It is usually felt on both sides of the head as a dull pressure or tightness, sometimes described as a band around the head. It is generally mild to moderate and does not usually stop you getting on with your day, although it can be draining when it happens often.
When to get urgent help
Call 999 or go to A&E straight away if you have a headache with any of these.
- A sudden, severe headache that reaches full intensity within a minute or so
- Headache with confusion, weakness, speech difficulty, vision loss, facial droop or seizures
- Headache with a stiff neck, high temperature, rash or dislike of bright light
- Headache after a head injury
What it can feel like
- A dull, pressing or tightening ache, usually on both sides of the head or across the forehead
- Tight, tender muscles in the neck and shoulders
- A headache that lasts from 30 minutes to several hours, and sometimes several days
- Usually without the nausea, vomiting or marked light sensitivity that often come with migraine
Common contributors
- Stress, tiredness and poor or irregular sleep
- Long spells of screen use and eye strain
- Skipped meals and not drinking enough water
- Tension in the neck and shoulder muscles after long periods in one position
- Taking painkillers too often, which can itself cause headaches
General self-care
These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.
- Drink plenty of water and keep to regular meals and sleep times
- Rest, and try to relax. Stress can make headaches worse
- Take regular breaks from screens and look at something in the distance to rest your eyes
- Short walks and gentle neck and shoulder movement can ease built-up tension
- Paracetamol or ibuprofen can be used for a headache, but follow the packet instructions and speak to a pharmacist if you find you need them on most days
When to see your GP
See your GP promptly, or call NHS 111, if you notice any of the following:
- A new headache pattern, particularly if you are over 50
- Headaches that are triggered or made worse by coughing, sneezing, bending or exercise, or that wake you at night
- Jaw pain when eating, a sore or tender scalp, or problems with your vision or eyes
- Headaches that are becoming more frequent or more severe
Consider seeing your GP if:
- Self-treatment is not helping, or the headaches are getting worse
- You get headaches regularly, or need painkillers on most days
- The headaches are a new pattern for you, particularly if you are over 50
Where an osteopath fits in
There is limited good-quality research showing that hands-on treatment changes the course of tension-type headache, so I do not claim that osteopathy treats it.
Research on hands-on treatment for tension-type headache is mixed, and it is best seen as one possible part of a wider plan rather than a stand-alone answer.
What an osteopath can usefully do is assess how your neck, upper back and jaw are moving, talk through the triggers in your day (posture, screens, sleep, stress and painkiller use), ease neck and shoulder tension where that is a feature, and suggest what to track in a headache diary before seeing your GP. If the assessment suggests you need your GP, a physiotherapist or a specialist instead, I will tell you.
If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.
Common questions
What is the difference between a tension headache and a migraine?
Tension-type headache is usually a dull pressure on both sides without the nausea, vomiting or marked light sensitivity that often come with migraine, which is typically throbbing and often on one side. If you are unsure which you have, or the pattern is changing, see your GP.
How long does a tension headache last?
The NHS says headaches in general can last 30 minutes, several hours or sometimes several days. If they keep coming back or are not responding to self-care, see your GP.
Sources and further reading
Links open in a new tab. Sources were checked in October 2026.
Related guides
This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.