According to the Mayo Clinic, the precise cause or causes of tension headaches are not known. Contributing factors may include contraction of the face, neck and scalp muscles due to elevated emotions or excessive stress and tension, although research suggests that a definitive link between muscle tension and tension headaches may not exist. Instead, brain chemical changes may be the most significant cause of tension headache. Common tension headache triggers may include poor posture, stress and brain chemical changes.
Poor Posture
The Mayo Clinic states that poor posture can contribute to the onset of muscle tension headaches. Maintaining good posture, with the spine in proper alignment and the body's weight distributed evenly over the weight-bearing joints, can prevent muscles from tensing up. Maintaining proper posture reduces the strain on the muscles, ligaments, tendons, joint and bones; protects and stabilizes the body's joints; and helps a person move efficiently. According to a 2006 study by César Fernandez-de-las-Peñas and colleagues published in the journal Headache, the degree of forward head posture or anterior head carriage---a common finding in those with poor posture---correlates positively with tension-type headache duration, frequency and the presence of active myofascial trigger points, which are hyperirritable nodules in a tight band of muscle, in the suboccipital muscles. The suboccipital muscles are located at the base of the skull and typically are tight in those with excessive anterior head carriage.
Stress
Stress plays a significant role in the onset of tension headaches. According to a 2005 study by researchers at Ohio University's Department of Psychology published in Headache: The Journal of Head and Face Pain, those who suffered frequent tension headaches reported more chronic daily stressors or hassles than members of the control group, regarded the stressful events they experienced more negatively, and used less effective coping strategies to manage stressful situations. The University of Maryland Medical Center states that stress is a common precipitating factor, or trigger, for tension headaches and that good health habits are important for reducing stress and the incidence of tension headaches. Good health habits include the following: getting adequate sleep, eating a healthy diet, getting regular exercise, quitting smoking, and practicing meditation or relaxation techniques.
Brain Chemical Changes
The Mayo Clinic states that researchers now believe tension headaches may arise due to changes in certain brain chemicals, including neurotransmitters such as serotonin and endorphins, among others, that assist nerve communication and involve pain sensitivity and perception. Although it's unclear why brain chemical levels rise and fall, the process is believed to stimulate pain pathways to the brain and alter the brain's ability to quell pain. According to the University of Maryland Medical Center, nitric oxide, which is involved in nociceptive pain processing, may also be involved in the chemical changes that produce tension headaches. A 2000 study by M. Ashina and colleagues published in the journal Brain notes that nitric oxide contributes to the mechanisms of several types of primary headaches, including tension-type headaches.
References
- Mayo Clinic: Tension Headache
- Headache; Forward Head Posture in Tension-Type Headache; César Fernandez-de-las-Peñas, P.T., et al.; 2006
- Headache: The Journal of Head and Face Pain; The Role of Stress in Recurrent Tension Headache; Jeffrey E. Holm, M.S., et al.; 2005
- University of Maryland Medical Center: Tension Headache
- National Institute of Neurological Disorder and Stroke: Headache: Hope Through Research
