Tension-type headache and migraine causes

Woman with a headache

What are they?

Tension-type headache

Tension-type headache (TTH) is a head pain that occurs in frequent or infrequent shorter episodes (episodic**) or that is regularly or constantly present (chronic).1 TTH are usually mild or moderate in intensity and may present as a “pressing” or “tightening” quality. It is usually not aggravated by physical activity.


Migraines on the other hand, are severe and disabling attacks that reoccur over time and often felt on one side of the head. It has a “pulsating” quality and is often associated with changes in light, sound and odour sensitivity. It is usually accompanied by nausea and neck stiffness. Patients will experience seeing spots or stars during attacks and, feeling fatigued or dizzy after.2,3

Pathophysiology, causes and triggers of tension-type headaches

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Pathophysiology of tension-type headaches4

Unlike migraines, the mechanism of TTH is not clearly known. It may originate from tensed muscles especially around the neck area and can be stress-related.

  • Woman with a headache

    TTH are caused by either factors related to increased feeling of stress and/or problems with the neck muscles.

  • Man with a headache

    The triggers for TTH are similar to migraines. The main trigger is related to stress or mental tension. Other triggers associated with TTH are sleep problems, fatigue, weather changes, menstruation and the inability to relax after work.

Understanding headaches

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Headaches overview

Find out more about how headaches impact people’s life.


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How do they present?

Find out the signs and symptoms of tension-type headache. Learn to differentiate them from migraine* and learn about “red flag” symptoms that indicate a referral to a doctor.

Signs and symptoms

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What can you recommend to your patients for pain relief from their headaches?

Find out more about both non-pharmacological and pharmacological treatments for tension-type headache.


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Educational resources

Educational resources

Download resources for your patients.


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When to refer children with fever

Learn more about “red-flag” symptoms when children present with fever.

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Patient care resources

Patient care resources

Download resources for your patients.