Tension headache: how to recognise it and what you can do yourself

General information, not medical advice. If you suddenly get a very severe headache you have never had before, call your GP or the out-of-hours service straight away.

A pressing feeling around your head after a long working day, as if a tight band were wrapped around it. That is what a tension headache feels like for many people. According to the NHS it is very common and according to Thuisarts it is not dangerous. This article explains how to recognise it, what triggers it and what you can do yourself.

How to recognise a tension headache

Thuisarts, the patient website of the Dutch College of General Practitioners (NHG), describes a tension headache as a tightening or pressing pain on both sides of your head. The muscles in your neck or shoulders may be stiff or sore. Bright light or loud noise can make the pain worse. You may have less appetite, but you usually do not feel sick.

One key feature: the pain does not get worse when you move. You can usually carry on with your work or daily activities. That is different with migraine. According to Thuisarts, a migraine is an attack of severe, often throbbing pain on one side, which gets worse when you climb the stairs, for example. With migraine you may also feel sick. Some people have both.

An episode of tension headache lasts from half an hour to a few days. It comes back regularly, for example 1 day a month or more often, up to 15 days a month. If you have a headache on more than 15 days a month for more than 3 months a year, doctors call it chronic tension headache. Mainly adults get tension headaches, women more often than men. It becomes less common as you get older.

Is a tension headache caused by stress?

The name suggests so, but the answer is less simple than you might think. According to Thuisarts, doctors do not know exactly how tension headaches start. Pain signals from your neck muscles, for example, may play a role. If you have headaches often or for a long time, you can also become more sensitive to pain. Whether stress or tense muscles are the cause is not known, Thuisarts says. The other way round, the headache can make you feel tense, which can keep it going.

The British NHS does list stress, sleep problems and caffeine as common triggers. Both sources agree on one thing: taking painkillers too often can itself cause headaches.

What you can do yourself

According to Thuisarts, a healthy lifestyle matters most. Try to get enough sleep, make time to relax every day, eat healthily and move enough every day. If you have worries, talk about them with someone you know well or with your GP. Keep going with your work and other activities too, as this can help ease the headache.

The NHS suggests trying to relax with exercise, yoga or massage. Calm breathing when you feel tense is another simple way to settle down. If you drink a lot of coffee, tea or cola, the NHS advises cutting down. How caffeine affects your sleep is explained in the article on stopping caffeine before sleep. If you also have neck pain, a low, firm pillow and a heat or cold pack can help.

Using painkillers wisely

If that is not enough, you can take a painkiller now and then. Thuisarts advises starting with paracetamol, because it usually works well and has the fewest side effects. Always follow the leaflet or ask your pharmacist. Only take painkillers when you have a headache, not because you are afraid one is coming. Use them for a few days, no longer. Otherwise you may actually get more headaches.

When to see your GP

Make an appointment if you take painkillers now and then and still have a lot of pain, or if you want help coping better with the headaches. The NHS also recommends this if you get headaches several times a week, if they are severe or if you have a throbbing pain on one side with nausea. That can point to a different type of headache, such as migraine.

Call your GP or the out-of-hours service straight away for a very severe headache you have never had before, or if you also have other symptoms. According to the NHS, urgent help is also needed if you get a headache after a fall or accident, or if a severe headache comes with sudden problems speaking or loss of vision.

Sources

• Thuisarts, Nederlands Huisartsen Genootschap (NHG). Ik heb spanningshoofdpijn. 2026 (last updated 24 September 2026), in Dutch.
• NHS (United Kingdom). Tension headaches. Accessed November 2026.