Symptoms of Tension Headaches

A Pressing or Tight Sensation Felt on Both Sides of the Head

The symptoms of a  tension headache include a dull, band-like discomfort around the head that may be accompanied by muscle tenderness in the neck and shoulders. Tension headaches last from 30 minutes to seven days and can be triggered by several factors, including stress, lack of sleep, skipping meals, or alcohol consumption.

A tension headache is the most common type of headache, with up to 78% of individuals experiencing one or more in their lifetime.  

This article explores tension headache symptoms and the complications that may arise if the headache becomes chronic.

Dark-haired woman sitting on couch, rubbing temples, appears to have a headache

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Frequent Symptoms

Tension headaches cause a pressing, squeezing, or tightening sensation that commonly starts at the forehead before wrapping around the sides and back of the head.

A tension headache may feel like you are wearing a tight headband or an extra-small baseball cap. Some people even describe it as feeling like their head is in a vise.

While unpleasant and nagging, tension headaches are not dangerous. Due to their mild to moderate discomfort, most people can get on with their daily routine, although they may be irritable, have difficulty focusing, or lose their appetite.

Muscle tenderness in the head, neck, or shoulder is a common accompanying symptom of tension headaches. This phenomenon, called pericranial tenderness, is caused by muscle tensing or contracting in the forehead, temples, jaw, and neck.

Research suggests pericranial tenderness is linked to the intensity and frequency of tension headaches and may be a response to stress, anxiety, or poor posture.

Other possible symptoms of tension headaches are light sensitivity (photophobia) or sound sensitivity, but not both.

Frequent Tension Headache Symptoms

Frequent symptoms of tension headaches include:

  • Pressing or tightening sensation felt on both sides of the head
  • Steady mild to moderate pain
  • Head, neck, or shoulder muscle tenderness
  • Light sensitivity
  • Sound sensitivity

Rare Symptoms

The pain associated with a tension headache is rarely severe, throbbing, or located on one side of the head. These features are much more typical of migraines, another common headache disorder.

Additionally, while the vast majority of tension headaches are not associated with nausea, mild nausea may occur with chronic tension headaches.

Chronic tension headaches occur daily or at least 15 or more days a month and affect up to 4% of the general population. They are more common in women and may last hours or be continuous.

Note that Verywell Health prefers to use inclusive terms. But when citing research, the terms for gender and sex from that source are used.

Rare Tension Headache Symptoms

Rare tension headache symptoms include:

  • Severe, throbbing pain
  • Unilateral (one-sided) headache
  • Mild nausea (seen only in chronic tension headaches)

How to Know If You Have a Tension Headache

Keeping a headache diary can help your healthcare provider determine if you are experiencing a tension headache.

In your diary, try to include these key points:

  • Location and severity of your headache
  • Eating and sleeping habits before your headache started
  • Presence of any stressors around the time of your headache. (e.g., a meeting with your boss or caring for a sick child)
  • Associated symptoms (e.g., light sensitivity, nausea, vomiting)
  • If anything relieves your headache (e.g., medication, a nap, a hot bath)

When diagnosing your headache, a healthcare provider will look at your headache diary, ask about your symptoms, and perform a neurological exam. Imaging or other diagnostic tests will likely be done if your neurological exam is abnormal but may not be needed otherwise.

A healthcare provider may also look for pericranial tenderness if a tension headache is suspected. They can do this by applying firm pressure and making small circles with their index and middle fingers on the muscles within or near the forehead, temples, jaw, and neck.

Typical symptoms, especially if neck/head muscle tenderness is also present, are usually sufficient to diagnose a tension headache.


Headache complications are health issues that can arise from an underlying headache disorder.

While tension headaches can undoubtedly be a nuisance, the good news is that they are not medically harmful. Tension headaches are also not generally disabling unless they occur frequently.

With frequent or chronic tension headaches, individuals may experience a poorer quality of life or increased stress. They may also miss more days at work or have reduced work efficiency.

Individuals with chronic tension headaches are also at increased risk for mood disorders, especially anxiety and depression. They may also be more likely to experience anger and emotional distress.

When to See a Healthcare Provider

Most headaches, especially tension headaches, are not a cause for worry. In rare instances, though, a headache can be the first or only sign of another health condition.

The following scenarios indicate times when you should not ignore your headache but instead see a healthcare provider:

  • Your headaches are new, occurring more often, worsening, or feeling different than usual.
  • Your headache is triggered by sneezing, coughing, exercising, standing, or bending over.
  • You have a headache and other specific health problems/issues like a history of cancer or human immunodeficiency virus (HIV), current or recent pregnancy, or are 65 years or older.
  • You are overusing painkillers and experiencing headaches (possible medication overuse headache).

Get Emergency Medical Attention

Go to your nearest emergency room or call 911 immediately if:

  • A headache comes on suddenly and escalates to being severe within a few seconds or minutes.
  • You have a headache and any of the following: fever, stiff neck, painful red or tearing eye, vision changes, seizure, fainting, or stroke symptoms.
  • A headache comes on after head trauma.


Tension headaches are very common and cause a pressing or tightening sensation around the entire head. The pain of tension headaches is mild to moderate in intensity and may be accompanied by muscle tenderness in the neck, head, and shoulders. Light or sound sensitivity can also be present.

Tension headaches, while nagging and unpleasant, are not usually debilitating, unless they become chronic.

A Word From Verywell

If you are diagnosed with tension headaches, work closely with a healthcare provider to devise a treatment plan that is effective and safe for you. They might suggest taking an over-the-counter pain reliever like Advil (ibuprofen) or Tylenol (acetaminophen) at the onset of headache symptoms.

You may be able to prevent tension headaches by maintaining a consistent sleep and meal schedule and taking time each day to decompress and relax.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.