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Can Tension Headaches Cause Migraines

Getting The Right Diagnosis

Diagnosing tension headaches

TTH is diagnosed if the patient has experienced at least 10 attacks, each lasting somewhere between 30 minutes and 7 days. Each headache attack is accompanied by pain that fits at least two of the following characteristics:

  • Does not pulsate or throb
  • Located on both sides of the head
  • Mild-to-moderate intensity
  • Is not aggravated by routine physical activity

If symptoms like nausea, vomiting, light and sound sensitivity are present in addition to the headache, doctors will generally consider Migraine as a more plausible diagnosis over TTH.

Migraine is diagnosed if a patient has experienced five or more attacks, with the following characteristics:

  • Attack lasts 4-72 hours
  • Aggravated by routine physical activity
  • During the attack, at least one of the following symptoms is present:
  • Nausea and/or vomiting
  • Light and sound sensitivity
  • An experienced doctor or headache specialist can help differentiate amongst the various types of headaches, including TTH and Migraine.

    Although there are no specific tests for Migraine, your doctor may recommend a scan or blood test to rule out other conditions that may be triggering your headaches.

    Migraine is a genetic disorder that you’re born with. Your doctor may ask for details about your health history and the health history of your family members.

    Are There Ways To Prevent A Mixed Tension Migraine

    Although the exact cause of migraines isnt understood, its clear that some things can trigger a migraine. Avoiding your headache triggers can help prevent mixed tension migraines.

    Try keeping a log of your headaches, what you ate or drank, and your surroundings before you felt a mixed tension migraine. Use this record to figure out what triggers your headaches.

    Common headache triggers include:

    • alcohol, especially beer and red wine
    • bright or flashing lights
    • particular foods or food additives like nitrates
    • not enough sleep or too much sleep
    • menstruation and other changes in hormone levels
    • overuse or withdrawal from certain medications

    How Are Tension Headaches Diagnosed

    Tension headaches are mainly diagnosed based on the symptoms you report. A thorough medical exam, which may include other tests or procedures, may be used to rule out underlying diseases or conditions.

    Tracking and sharing information about your headache with your healthcare provider helps make an accurate diagnosis.

    Questions commonly asked during the exam may include:

    • When do headaches occur?
    • What is the location of the headache?
    • What do the headaches feel like?
    • How long do the headaches last?
    • Have there been changes in behavior or personality?
    • Do changes in position or sitting up cause the headache?
    • Do you have trouble sleeping?
    • Do you have a history of stress?
    • Have you had a head injury?

    If the history suggests tension headaches and the neurological exam is normal, no further testing may be needed. But, if the headache is not found to be the main problem, then other tests may be needed to determine the cause such as:

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    Migraine Vs Headache Diagnosis

    Although there are no specific tests for migraine headaches, your doctor may order tests to exclude other conditions or problems that are triggering your headaches. This may include blood work or different brain imaging, such as CAT scan or MRI. In rare cases, your doctor may order a spinal tap to exclude causes of more serious, severe headaches.

    A doctor who is experienced in treating various headaches can help differentiate the type of headaches that you have. A sinus headache often mimics some signs and symptoms of migraines.

    Monitoring the duration of your headache can provide important information that can help diagnosis the type of headache you are experiencing. Migraine headaches may last a few hours to three days, while tension headaches may last only 30 minutes or linger for up to a week.

    • Keep a headache diary to help identify triggers that lead up to the onset of the headache, for example, menstrual cycles for women, hormone treatments, and alcohol intake.
    • Keep track of when a headache begins, the severity of the pain, any associated symptoms, how long the headache lasts, and any medications that you have taken.
    • If there does not seem to be any clearly identifiable cause for your headaches, maintain a diet diary, and keep track of any foods or drinks that you may have consumed the day before a headache to identify possible triggers.

    How Is A Tension Headache Diagnosed

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    Most tension-type headaches are diagnosed based on a complete and comprehensive history and physical examination. No further diagnostic studies are needed for people who have normal neurological examination findings and are otherwise healthy.

    In contrast, people with chronic tension-type headache, regardless of whether they have normal neurological examination findings, should have a CT scan and MRI. Although this sophisticated imaging does not diagnose a specific type of headache syndrome, it may prove invaluable in excluding other causes of the headaches. Thyroid function studies, complete blood cell count, and metabolic screening should also be performed.


    Most people with tension-type headache find relief with over-the-counter medications such as aspirin, acetaminophen , and other nonsteroidal anti-inflammatory drugs .

    • Certain people may require prescription-strength pain relievers for particularly severe episodes.
    • Frequent use of medications to treat symptoms of headache may actually cause episodic tension-type headache to become chronic in nature.

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    How Is A Mixed Tension Migraine Diagnosed

    There is no test for mixed tension migraine. Your doctor can form a diagnosis based on your symptoms and by ruling out other causes of your symptoms.

    If youre experiencing symptoms of a mixed tension migraine, your doctor will begin by taking your health history. Theyll ask you about your symptoms, including where you feel the pain, what the pain feels like, and how often the headaches occur.

    Your doctor will also ask you about your familys history with headaches. This is because migraines may have a genetic link. Most people who experience migraines have a family member who also experiences migraines.

    Your doctor may perform a neurological exam to rule out neuropathy and neurological disorders that can cause similar symptoms. During this exam, your doctor will test your reflexes and muscle tone. Theyll also test your response to different kinds of stimuli like light touch, temperature, and vibration. The results will tell your doctor if your nervous system is functioning normally.

    Your doctor may order a CT scan or MRI scan of your head and neck. These tests will provide your doctor with an image of your brain and brain stem to see if your symptoms are being caused by a problem in your brain.

    Your doctor may also order blood work to determine if underlying conditions are causing your headaches.

    Treatment options for mixed tension migraine can include treatments for both tension headaches and migraines. The treatment will depend on your symptoms.

    Home Remedies For Migraine

    Prevention is always better than trying to treat a headache that’s already underway. Try these strategies at home to prevent Migraine attacks and better manage your symptoms.

    1 – Drink Plenty of Water. Dehydration is a common trigger of TTH and Migraine attacks

    2 – Relax with Yoga. Practicing yoga is an excellent way to relieve stress, reduce the intensity and frequency of headaches, and improve your overall quality of life.

    3 – Avoid Strong Smells. Strong peculiar odors of certain perfumes and cleaning products may be the possible triggers.

    4 – Use Ginger. Ginger helps ease stomach discomfort and nausea.

    5 – Try Supplements for Prevention. Magnesium, CoQ10, and B2 all have evidence behind them.

    6 – Avoid Foods High in Histamine. Histamine is naturally present in the body and plays a role in the immune, digestive and nervous systems. Commonly found in certain foods like aged cheeses, fermented food, beer, wine, smoked fish and cured meats.

    7 – Use Essential Oils. Essential oils are highly concentrated liquids that contain aromatic compounds from a variety of plants. They offer many therapeutic benefits, often used topically. Peppermint and lavender essential oils are especially helpful when you have a headache.

    8 – Try an Elimination Diet. Research suggests that food intolerances can trigger headaches. The best way is to avoid food that causes a headache. Try an elimination diet that removes the foods most related to your headache symptoms.

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    How Neck Pain May Feel With Tension Headache

    Neck pain that may accompany a tension headache typically feels achy, tender, and/or tight. In cases where neck pain started before the tension headache, such as from trauma or a chronic neck condition, the neck pain may feel more intense, such as sharp or burning. Sensitivity of the trapezius muscle in the upper neck is common in tension headache, along with stiffness of the neck and scalp muscles.

    There are 3 types of tension headache depending on frequency 1:

    • Infrequent episodic tension headache: Lasts less than 12 days per year
    • Frequent episodic tension headache: Lasts more than 12 days and less than 180 days per year
    • Chronic tension headache: Lasts more than 180 days per year

    While infrequent episodic tension headache is usually self-managed, frequent episodic and chronic tension headache can cause high disability and prompt medical consultation.

    Are There Any Risks To Taking Medication To Treat Tension Headaches

    Migraine & Tension Headaches

    Over-the-counter pain relievers are generally safe. But overusing pain relievers can cause other problems. Make sure to follow the instructions on the bottle carefully. Always check in with your provider if you feel the need to use pain relievers more than twice a week.

    Take these medications only when you need them. Use the smallest dose that relieves your pain.

    In general, overusing pain medications may cause:

    • Headaches: Taking pain relievers too often can actually cause a headache when you stop taking the medicine. This effect is similar to withdrawal.
    • Other side effects: All drugs have side effects. Avoid taking aspirin or other nonsteroidal anti-inflammatory drugs , such as ibuprofen, too often. Overuse may cause stomach pain, bleeding or ulcers. If you take any medication regularly, discuss the risks and benefits with your doctor.
    • Reduced benefits over time: Your body can build up a tolerance any medication. You may notice that a medication youve used regularly doesnt work as well as it once did.
    • Dependence: Some medications can become addictive. They may pose more risks than benefits. For that reason, healthcare providers usually recommend against prescribing benzodiazepines and narcotics to treat tension headaches.

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    How To Prevent An Anxiety Heavy Head And Headache

    While you may not entirely prevent headaches from occurring, you can take some steps to help decrease their frequency and severity. These include:

    • Recognize Your Triggers: When you get migraines, try and identify what triggers them, including stress, caffeine, alcohol, hormonal changes, insufficient or low-quality sleep, and dehydration.
    • Practice Relaxation: Take time off your daily schedule to relax to reduce anxiety symptoms. Some physical exercises can help you relax, especially when you rest and sleep enough. Additionally, you can practice mindfulness exercises such as meditation, guided imagery, and progressive relaxation therapy.
    • Practice Self-Care: Anxiety affects your sleep, appetite, and overall health. Therefore, practicing self-care helps reduce many anxiety symptoms, including headaches. For example, get seven to nine hours of restful sleep daily, do regular physical activity, drink enough water, and avoid skipping meals.

    When A Migraine Is Actually A Mixed Tension Headache

    The pain of a migraine is extremely debilitating. It may sound a little strange, but a person can actually have another headache in addition to a migraine at the same time. These are sometimes referred to as mixed tension headaches, transformed migraines, or chronic migraines. No matter what the name is, the pain is horrible, and some may not even realize they are suffering from a second headache.

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    Role Of The Spinal Curvatures

    The spines healthy curvatures facilitate flexible movement and help us maintain a straight and upright posture.

    The spinal curvatures work together in a spring-like function, and this makes it possible for the spine to absorb and evenly distribute shock and impact.

    If the spine was straight with no curves, it would take on a lot of degenerative wear due to the uneven distribution of mechanical stress. This would lead to spinal injuries such as fractures and worse.As the curvatures help to evenly distribute shock and weight throughout, the muscles that closely surround the spine are worked evenly to support and balance the body.

    These concepts are particularly evident when engaging in dynamic movements.

    With dynamic movements such as bending, turning, twisting, and lifting, the spine is required to coordinate with the rest of the body, but it has to do all this while supporting the bodys weight and distributing the transfer of energy caused by the dynamic movements.

    The curves of the spine help to evenly distribute shock and weight throughout so that no one section is getting overworked.

    The curves of the spine also help preserve the intervertebral discs.

    The intervertebral discs sit between the bones that make up the spine: vertebrae. The discs help to cushion each individual vertebra so they are not rubbing up against each other.

    They also help absorb the stress and shock that occurs during movement.

    The Tension Headache May Cause Headache At Base Of Skull

    Handy Charts to Help Deal with Migraines

    Trigger points and muscle tension are two common causes of tension headaches. Do you ever wonder why your skull feels so painful? It can be quite distressing, especially if it spreads. Here is some information from physiotherapists about possible causes and pain relief.

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    What Are Some Triggers That May Bring On Tension

    You may be more likely to have tension headaches if you have:

    • Eye strain, such as from staring at a computer screen for a long time.
    • Pain in other parts of your head and neck caused by problems such as temporomandibular disorders.
    • Problems sleeping, such as insomnia.
    • Stress related to family, work or life challenges, such as starting or losing a job or juggling too many commitments.

    Outlook For People With Tension Headaches

    Tension headaches often respond to treatment and rarely cause any permanent neurological damage. Still, chronic tension headaches can affect your quality of life.

    These headaches can make it difficult for you to participate in physical activities. You may also miss days of work or school. If it becomes a serious problem, talk to your healthcare provider.

    Its important to not ignore severe symptoms. Seek medical attention immediately if you have a headache that starts suddenly or a headache accompanied by:

    • slurred speech

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    What Is Chronic Tension Headache And Who Is Affected By It

    Chronic tension headache is a condition where you have a tension headache on at least 15 days every month for at least three months.This can be tiring and depressing. Tension headache is the common type of headache that most people have at some time.

    It’s not known exactly how common chronic tension headache is, as few studies have looked at this clearly. Some studies have estimated that around 1 in 30 of all adults have chronic tension headaches – which means they have a headache on more than half of all days for three months or more. However, it is possible that a proportion of these patients actually have developed medication-overuse headaches as a result of their tension headaches. Therefore, it can be difficult to be certain which is their main problem.

    Chronic means persistent it does not mean severe. The severity of the headaches can vary from mild to severe. Because of the persistent nature of the headaches, however, this condition is often quite disabling and distressing, and most patients take preventative medication.

    Central Nervous System Function

    What is a tension headache?

    The brain and spinal cord work together to form the central nervous system, which plays a role in virtually every working system within the body.

    The spine also protects the spinal cord: a column of nerves connecting the brain to the rest of the body so that messages can be relayed back and forth.

    The CNS controls reflexes, general movement, organ function, and the mind through a complex communication network.

    The brain is the nucleus of our thoughts and mental health it is also the means by which we interpret the external environment with our internal responses.

    Now that we have looked at the significant roles the spine plays in the overall health and function of the body, lets take a look at some basic spinal anatomy this will help us get a clear understanding of how scoliosis affects the spine, and how those effects can be expressed throughout the body.

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    Living With Tension Headaches

    You may have fewer headachesand less pain when you do get themif you:

    • Find and avoid triggers for your headaches.
    • Keep a headache diary to find out what triggers your headaches.
    • Take over-the-counter drugs to stop a headache.
    • Take medicine as your doctor advises to stop or prevent a headache.
    • Reduce stress with relaxation and positive-thinking methods.

    Keeping A Headache Diary

    Keeping a headache diary with the duration, triggers and impact of your headache can help your doctor correctly diagnose the type of headache you’re experiencing.

    Be sure to include the following information in your headache diary for a complete picture:

    • Duration. Migraine may last from a few hours to three days, while tension headaches may last from 30 minutes up to a week.
    • Triggers. Identify triggers that caused or aggravated the symptoms, like weather change, menstrual cycles for women, hormone treatments, and alcohol intake.
    • Pain. When is it increasing and after how much time does it subside? If medicine is taken, how long did it take to feel better?
    • Diet. Track the food and drink that you may have consumed the day before a headache to identify possible triggers

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