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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Tension headaches are recognised from your description and treated by video; a headache with warning signs needs urgent in-person care.
- What it feels like: pressure or tightness on both sides of the head, like a tight band, mild to moderate, and you can carry on with your day.
- How common: the most common type of headache. More than 70% of people in some populations have episodic tension-type headaches, and about 50% more women than men are affected.
- How long it lasts: at least 30 minutes, sometimes several days. Headaches on 15 or more days a month for more than 3 months are called chronic.
- Emergency: call 112 for a sudden, severe headache that reaches its worst within 5 minutes, a headache with a high temperature and a stiff neck, new weakness, numbness or confusion, or a headache after a head injury.
Do not book a video appointment for a headache that came on suddenly and is extremely painful, a headache with a high temperature, a stiff neck or a rash that does not fade when a glass is rolled over it, a headache with weakness, numbness, slurred speech, loss of vision, drowsiness, confusion or a seizure, or a headache after a head injury. Call 112 or go to an emergency department.
Can an online doctor treat tension headaches?
Yes. Tension-type headache is diagnosed from your description rather than a scan or a test, so a doctor can recognise it by video, tell it apart from migraine and medication overuse headache, and agree a plan: which painkiller, how often, what to change, and preventive treatment if the headaches are frequent. A headache with warning signs needs urgent in-person care, and acupuncture is given in person.
How an online consultation helps with tension headaches
- Tension headache or migraine?: A mild migraine can be hard to tell apart, and the right treatment differs.
- A painkiller plan that protects you: Painkillers taken too often can cause headaches themselves, and the doctor counts your days with you.
- Prevention when they are frequent: Lifestyle changes, a preventive medicine or acupuncture when headaches come most days.
- Warning signs checked: Headaches that are new, changing or come with other symptoms are checked before anything else.
What the doctor checks in an online tension headache consultation
The doctor asks about the warning signs first, then about the headaches themselves. The doctor asks about:
- Warning signs: a sudden, severe start, a high temperature, a stiff neck, weakness, numbness, vision problems, confusion, a recent head injury, or jaw pain when eating and a sore scalp.
- The headache: where it is, what it feels like, how long it lasts, and whether you can carry on with your day.
- Other symptoms: feeling sick, being sick, or finding light or noise painful, which point to migraine.
- How often: how many days a month you have a headache, and how many days you take painkillers.
- Triggers: stress, sleep, caffeine, alcohol, screens, posture, eye strain, and jaw clenching or teeth grinding.
- Your health: pregnancy, other conditions and medicines, and any change in your headache pattern.
Before the call, keep a headache diary for a couple of weeks if you can: the days you had a headache, how bad it was, how long it lasted, what you took, and anything that might have set it off.
What does a tension headache feel like?
A tension headache feels like a dull, aching pressure or tightness around the head, often described as a tight band. Typically:
- the pain is on both sides of the head, across the forehead, the sides or the back of the head, or the face or neck
- it is mild to moderate, pressing or tightening rather than throbbing
- you can carry on with daily activities, and routine activity does not make it worse
- the scalp, neck and shoulder muscles can feel tender
- there is usually no feeling sick or being sick
Which symptom is most typical of a tension headache?
A pressing or tightening pain on both sides of the head that does not stop you doing things. Doctors diagnose a tension-type headache when the pain is on both sides, pressing or tightening, mild to moderate, not made worse by routine activity, and comes without feeling or being sick; a dislike of light or noise is uncommon.
How long does a tension headache last?
At least 30 minutes, and sometimes several days; a single episode can last up to a week. Doctors group them by how often they come:
Swipe sideways to compare →
| Type | How often | What it means |
|---|---|---|
| Infrequent episodic | Less than 1 day a month | Usually needs no more than an occasional painkiller |
| Frequent episodic | 1 to 14 days a month, for at least 3 months | Worth a plan for triggers and painkiller use |
| Chronic | 15 or more days a month, for more than 3 months | Prevention is worth discussing; check for medication overuse |
What causes tension headaches?
The exact cause is not known. The old idea that tight muscles from stress cause them is not supported by current research; the leading theory is that people with tension headaches are more sensitive to pain. Tension headaches are not a sign of an underlying condition, and they are not linked to brain diseases. Stress is the most commonly reported trigger. Others are:
- poor sleep, tiredness or overexertion
- caffeine, too much or suddenly stopping it, and alcohol
- holding your head still for long periods, for example at a computer, and poor posture
- eye strain
- jaw clenching or teeth grinding
- sleeping in a cold room or with your neck at an awkward angle
- colds, flu or a sinus infection
- heavy smoking
- taking painkillers too often
Tension headaches tend to run in families, and women are more likely than men to have frequent and chronic ones.
Why do I get tension headaches every day?
Headaches on most days are usually chronic tension-type headache, medication overuse headache, or both. Taking paracetamol, aspirin or anti-inflammatory painkillers on 15 or more days a month, or combination painkillers containing codeine on 10 or more days, for 3 months or more can itself cause daily headaches. The headache page explains how a doctor helps you stop the cycle.
Tension headache or something else?
A mild migraine can be hard to tell apart from a tension headache, and a few other headaches can feel similar. These are the differences:
Swipe sideways to compare →
| Headache | Where and how it hurts | Other clues | Online care |
|---|---|---|---|
| Tension headache | Both sides, pressing or tight, mild to moderate | You can carry on; no sickness | Treated online |
| Migraine | Often one side, throbbing, moderate to severe | Feeling sick, light and noise sensitivity, worse with activity; 4 to 72 hours | Treated online |
| Medication overuse headache | A dull headache on most days | Painkillers on 10 to 15 or more days a month | Treated online |
| Cluster headache | Severe pain around one eye | A red, watering eye, a blocked nose, restlessness | Assessed online |
| Giant cell arteritis | A new headache, usually over 50, often at the temples | Jaw pain when eating, a tender scalp, vision problems | Assessed online, treated in person urgently |
| Headache from a serious cause | Sudden, severe, or with other symptoms | Fever and stiff neck, weakness, confusion, after a head injury | Call 112 |
Pain at the back of the head and neck is covered on the occipital neuralgia page, and pressure behind the eyes on the headache behind the eyes page.
Which tension headache treatment might the doctor recommend?
Treatment follows how often the headaches come and how you use painkillers. This is the framework the doctors use, in line with NICE guidance:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| An occasional tension headache | Paracetamol, aspirin or an anti-inflammatory painkiller, with rest and fluids | Yes | Not usually needed |
| Several a week, or a few a month that are severe | A diary, trigger changes and a painkiller plan | Yes | If the pattern changes |
| Headache on 15 or more days a month | A check for medication overuse, and prevention such as amitriptyline | Yes | If prevention does not help: a specialist |
| Chronic tension-type headache, preferring not to take tablets | A course of acupuncture | Partly | For the acupuncture sessions |
| Painkillers on most days | A plan to stop the overused painkiller | Yes | If withdrawal is difficult |
| A new headache after 50, with jaw pain or a tender scalp | Urgent blood tests for giant cell arteritis | No | Urgently, in person |
| A sudden, severe headache, or one with warning signs | Emergency care | No | Call 112 now |
Headaches most days, or painkillers that have stopped working? A doctor can tell you in one consultation what is driving them.
See available times →Treatment options for tension headaches
How to relieve a tension headache
- Take paracetamol, aspirin or ibuprofen. Paracetamol is the first choice if you are pregnant, and children under 16 should not take aspirin.
- Use a heat pack or a cold pack on a tense neck, and massage the scalp, temples or the base of the neck.
- Try relaxing activity: a walk, stretching, yoga, or slow breathing.
- Drink plenty of water and eat regular meals.
- Take a break from the screen, and check your posture.
Painkillers help modestly. In a Cochrane review of 23 studies with 8,079 adults, 24 in 100 people were pain-free 2 hours after paracetamol, against 19 in 100 after a dummy tablet, and 59 in 100 had no or only mild pain, against 49 in 100. Taking them early, and not too often, works best.
Prescription treatment
A prescription is never issued without a consultation. If tension headaches are frequent or chronic, the doctor may prescribe amitriptyline to prevent them. It is started at a low dose, which may be increased later, and it usually takes several months to work. For chronic tension-type headache, NICE recommends considering a course of up to 10 acupuncture sessions over 5 to 8 weeks, which is given in person. Opioid painkillers, including codeine, are not recommended for tension headaches and are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Painkillers on more than 3 days a week, which can lead to rebound headaches. Codeine and other opioids. Too much paracetamol, which can damage the liver, or too much ibuprofen, naproxen or aspirin, which can irritate the stomach. Caffeine to push through the day. Sleeping much more than usual.
How can you prevent tension headaches?
Regular exercise, enough sleep and managing stress are the foundations of prevention. What helps:
- Move every day: regular exercise helps prevent them, and so do neck and shoulder exercises during computer or close work.
- Sleep: enough, but not too much, and change your sleep habits if poor sleep is a trigger; a low, firm pillow helps if you also have neck pain.
- Stress: relaxation techniques such as deep breathing, yoga, meditation and progressive muscle relaxation. Cognitive behavioural therapy and biofeedback can reduce how often headaches come.
- Daily habits: regular, balanced meals, plenty of water, less caffeine, alcohol and sugar, and not smoking.
- Posture and warmth: good posture when reading or working, and staying warm if cold sets them off.
- A diary: to find your triggers and count your painkiller days.
Combining medicines with stress management can work better than either alone. If you need painkillers on more than 2 days a week, or the headaches disrupt your life, see a doctor.
Special situations
Pregnancy
Paracetamol is the first choice, and ibuprofen is not recommended in pregnancy. A new, severe headache in pregnancy needs checking: see the headache page.
A new headache after 50
A first headache pattern starting after 50 needs a doctor, especially with jaw pain when eating, a sore scalp or vision problems, which can be giant cell arteritis.
Screens and desk work
Holding your head still at a computer, eye strain and poor posture are common triggers. Take regular breaks, exercise your neck and shoulders, and have your eyes tested if you have not done so recently.
Tension headaches while travelling in Europe
Travel brings poor sleep, long hours sitting still, dehydration and stress, which all set off tension headaches. Drink water, move around on long journeys, and pack a painkiller you know suits you. A new or unusual headache abroad still needs the same checks, and the warning signs mean 112.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When tension headaches are treated online, and when you need in-person care
Treated online: diagnosing tension-type headache, telling it apart from migraine, painkiller plans, preventive treatment for frequent or chronic headaches, medication overuse plans, and lifestyle and trigger advice.
In-person care: any headache with warning signs, a new headache after 50 with jaw pain or a tender scalp, acupuncture, and headaches that do not fit a clear pattern or keep changing.
When to get in-person care
Call 112 or go to an emergency department now for:
- a headache that started suddenly and is extremely painful, reaching its worst within 5 minutes (a thunderclap headache)
- a headache with a very high temperature, a stiff neck, sensitivity to light, or a rash that does not fade when a glass is rolled over it
- a headache with numbness or weakness in the face or body, slurred speech, loss of vision, or difficulty balancing or walking
- a headache with drowsiness, confusion or a seizure
- a headache after a head injury
- a headache with a red, painful eye
Get medical advice the same day for:
- a severe headache with jaw pain when eating, a sore scalp, or blurred or double vision
- a headache triggered or made worse by coughing, sneezing, bending down or exercise
- a headache with vomiting
- a headache that is worse when you lie down
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your headaches: say how often they come, what they feel like and how long they last, and how many days a month you take painkillers.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s a tension headache? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Migraine can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about tension headaches
What is a tension headache?
The most common type of headache: a dull pressure or tightness on both sides of the head, often like a tight band, that is mild to moderate and does not stop you doing things. It lasts from 30 minutes to several days.
What does a tension headache feel like?
A tension headache feels like a dull, aching pressure across the forehead, the sides or the back of the head, sometimes with tender scalp, neck and shoulder muscles. It is pressing rather than throbbing, and does not usually make you feel sick.
Which symptom is most typical of a tension headache?
The most typical symptom of a tension headache is a pressing or tightening pain on both sides of the head that does not get worse with routine activity and does not stop you carrying on. Throbbing pain on one side with sickness points to migraine instead.
What triggers tension headaches?
Stress is the most commonly reported trigger of tension headaches. Others are poor sleep, tiredness, caffeine or caffeine withdrawal, alcohol, long periods at a screen, poor posture, eye strain, jaw clenching, colds and flu, and taking painkillers too often.
How do you relieve a tension headache fast at home?
To relieve a tension headache fast, take paracetamol, aspirin or ibuprofen early, drink water, use a heat or cold pack on a tense neck, massage the scalp and neck, and take a break from the screen. Relaxation, a walk or stretching also help.
How long can a tension headache last?
At least 30 minutes, and sometimes several days, with a single episode lasting up to a week. Headaches on 15 or more days a month for more than 3 months are called chronic tension-type headache.
Why do I get tension headaches every day?
Daily headaches are usually chronic tension-type headache, medication overuse headache, or both. Taking simple painkillers on 15 or more days a month for 3 months can itself cause daily headaches, so a doctor counts your painkiller days with you.
How can I prevent tension headaches?
Exercise regularly, sleep enough, eat regular meals, drink plenty of water, cut down on caffeine and alcohol, take screen breaks, and manage stress with relaxation. For frequent or chronic headaches, a doctor may suggest amitriptyline or acupuncture.
What can be mistaken for a tension headache?
A mild migraine, medication overuse headache, cluster headache and, in people over 50, giant cell arteritis can all be mistaken for a tension headache. A sudden, severe headache or one with other symptoms needs urgent care.
Is a tension headache a sign of something serious?
No, tension headaches are not a sign of an underlying condition and are not linked to brain diseases. A headache that changes pattern, comes on suddenly or comes with other symptoms needs a doctor.
Can stress cause headaches every day?
Stress is the most commonly reported trigger of tension headaches, and chronic tension-type headache can occur on most days. Daily headaches also need a check for medication overuse, and stress management can reduce how often they come.
Can an online doctor treat tension headaches?
Yes, usually. A doctor can recognise a tension headache from your description by video, advise on painkillers and prevention, and prescribe amitriptyline when it is needed. A headache with warning signs needs urgent in-person care.
- Tension headaches, NHS, National Health Service (UK), reviewed 1 August 2025.
- Headaches in over 12s: diagnosis and management (CG150), NICE, National Institute for Health and Care Excellence, 2012, updated 2021.
- Could painkillers be causing your headaches?, NICE, National Institute for Health and Care Excellence, 2012.
- Tension headache, MedlinePlus, US National Library of Medicine, updated 27 October 2025.
- Tension headache: symptoms and causes, Mayo Clinic (US), updated 2 May 2026.
- Headache disorders, WHO, World Health Organization, fact sheet, 24 October 2025.
- Paracetamol (acetaminophen) for acute treatment of episodic tension-type headache in adults, Stephens G, Derry S, Moore RA. Cochrane Database of Systematic Reviews, 2016.
- Headaches, NHS, National Health Service (UK), reviewed 17 April 2024.
- Cluster headaches, NHS, National Health Service (UK), reviewed 18 August 2023.
- Giant cell arteritis: symptoms and causes, Mayo Clinic (US), updated 2 June 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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