Stress Headaches: Tension-Type Headache Explained and the Non-Drug Approaches With Evidence

The video is always the same. A confident hand presses two fingers into the hollow at the base of someone’s skull, holds for thirty seconds, and the caption promises that a “cortisol headache” has just been released. As of mid-2025 that clip, and dozens like it, has turned stress headaches into one of the most searched health phrases of the year. Search interest in “stress headache” and “tension headache relief” has climbed alongside the viral claim, and the questions landing in our inbox have shifted from “what is it?” to “does that trick actually work?”

It is a fair question, and it deserves a straighter answer than a caption can give. Tension-type headache is the most common headache in the world, and it is also one of the least glamorous: no aura, no dramatic imaging, no breakthrough drug. What it does have is a surprisingly deep, if imperfect, evidence base for approaches that involve no medicine at all.

This piece sorts that evidence by strength, names what is proven, what is plausible and what is simply untested, and tells you clearly when a headache stops being a lifestyle problem and becomes a reason to see a doctor.

What is a stress headache, and is it the same as a tension-type headache?

“Stress headache” is not a diagnosis you will find in any medical classification. It is everyday shorthand, and the condition it almost always describes is tension-type headache: the dull, pressing, two-sided head pain that most adults experience at some point in life. The World Health Organization calls it the most common headache disorder, and the International Classification of Headache Disorders, third edition (ICHD-3, the diagnostic rulebook neurologists use) gives it precise criteria.

The name has a history worth knowing. For decades doctors called it “tension headache” or “muscle contraction headache,” on the assumption that tight scalp and neck muscles were squeezing the head into pain. Studies measuring electrical activity in those muscles found it only modestly raised, and sometimes not at all, so the classification added the word “type.” Tension-type headache looks and feels like tension, but muscle tension alone does not explain it. Stress, meanwhile, is the trigger people report more than any other, which is why the two words fused in ordinary speech.

Why does the distinction matter to you rather than to a committee? Because what helps depends on what you have. A headache that is actually migraine responds to different measures, and a headache driven by frequent painkiller use needs the opposite of another tablet. Calling everything a stress headache can delay the right conversation.

So when this article says stress headaches, read tension-type headache: a real, classifiable, usually benign condition in which stress plays a leading but not solitary role. The evidence that follows is drawn from that definition, not from social-media labels.

What changed recently

Nothing about tension-type headache itself has changed; what has changed is attention. A few dated facts anchor the current moment.

In 2024 the WHO refreshed its headache disorders fact sheet with Global Burden of Disease figures: headache disorders affected roughly 40 percent of the world’s population, about 3.1 billion people, in 2021, with tension-type headache the most prevalent of them. That scale is one reason even small improvements in non-drug management matter at a population level.

The diagnostic framework in use today, ICHD-3, was finalised in 2018. It keeps the three-tier split of tension-type headache (infrequent episodic, frequent episodic and chronic) and sets the threshold for medication-overuse headache, a secondary headache caused by regularly taking pain relievers for a primary headache. Mayo Clinic, the NHS and Cleveland Clinic all now flag medication overuse prominently in their patient pages, a shift from a decade ago when it was a specialist concern.

On the evidence side, the most cited non-drug trial data remain the 2016 Cochrane review of acupuncture for tension-type headache, which pooled 12 randomized trials and 2,349 participants and concluded that acupuncture offers a modest but real benefit over sham treatment. No large new trial has overturned or extended that finding, and no medicine has been newly approved specifically for tension-type headache.

What is genuinely new is the viral framing. The “cortisol headache” label and the thirty-second “release” technique appear in no classification and no trial. The evidence base has not caught up with the claim because the claim has not been tested; treat that as a gap in the data, not proof either way.

Why does my head hurt? What stress actually does to muscles and nerves

The honest scientific answer to “why does my head hurt” is that tension-type headache is not fully understood. The most consistent physical finding is pericranial tenderness: the muscles of the scalp, jaw, neck and shoulders hurt more than they should when pressed, and the tenderness rises with how often and how badly a person’s head aches. That tenderness is measurable and reproducible, and it points to the muscles and the small nerves around them as the starting point for most episodic attacks.

What stress adds is a cascade. It raises resting muscle activity in the neck and jaw, shortens and fragments sleep, encourages clenching, and lowers pain thresholds, meaning ordinary sensations from those muscles are more likely to be read as pain. Cortisol, the stress hormone of the viral videos, is part of the body’s stress response, but no study has shown it directly causing a headache. Blaming one hormone flatters the complexity.

In chronic tension-type headache, the picture shifts from the muscles to the nervous system. Researchers describe central sensitization: the pain-processing pathways in the spinal cord and brain become more responsive over months, so signals that were once tolerable register as persistent pain. This is why long-standing daily headache often fails to respond to the same measures that worked when attacks were occasional, and why approaches that calm the nervous system (relaxation training, biofeedback, aerobic exercise) have a biological rationale rather than a wishful one.

Genetics plays a modest role, mostly in the chronic form. Dehydration, skipped meals, caffeine withdrawal, eye strain and poor sleep are well-recognized precipitants. The practical takeaway is that “stress” is usually several small physiological insults arriving together, which is also why several small interventions tend to beat one dramatic one.

Tension type headache symptoms: how to spot one

Tension-type headache has a signature, and ICHD-3 spells it out. Recognizing it takes a minute of honest observation.

• The pain is on both sides, often felt as a band around the head, a weight on top, or pressure behind the eyes and at the back of the skull.
• It presses or tightens rather than throbs. People reach for words like “vice,” “helmet” or “too-tight hat.”
• It is mild to moderate. You can usually keep working, if unhappily.
• Routine activity, such as climbing stairs, does not make it worse. In migraine it typically does.
• There is no nausea or vomiting in the episodic form, though mild queasiness can occur when it is chronic.
• Sensitivity to light or to sound may be present, but not both.
• An attack lasts anywhere from 30 minutes to seven days.

Alongside the head pain, many people notice tender scalp or shoulder muscles, difficulty concentrating, irritability and a sense that the pain builds through the afternoon and eases with rest. There is no aura: no zig-zag lights, no spreading numbness, no slurred words beforehand. If any of those appear, the headache is probably something else.

Children get tension-type headaches too, often around school stress, and describe them less precisely; parents tend to notice a child who is quieter, rubs the forehead and recovers quickly with rest.

One caution in the spirit of honesty: these criteria describe the typical case, not every case, and they are a tool for understanding rather than for self-diagnosis. A clinician uses the same checklist plus an examination, and the examination is the part you cannot do alone.

Stress headache vs migraine: telling them apart

The commonest mislabel in this field is calling a mild migraine a stress headache, and it matters because migraine has its own well-studied treatments and its own trigger patterns. Stress precipitates both, which is exactly why the label misleads.

Migraine is usually one-sided, though it can swap sides or involve both. It throbs or pulses in time with the heartbeat. It is moderate to severe, and movement makes it worse, so people seek a dark, quiet room rather than pushing on. Nausea is common, vomiting not rare, and sensitivity to light and sound together is typical. About a quarter to a third of people with migraine experience aura, the transient neurological symptoms that precede the pain. Untreated attacks last four hours to three days.

Tension-type headache is the mirror image on almost every line: both sides, pressing, mild to moderate, unaffected by activity, no vomiting, no aura. The simplest screening question is “did it stop you doing things?” A headache that cancels your evening is more likely migraine; a headache you worked through is more likely tension-type.

Two complications are worth knowing. People who have migraine also get tension-type headaches, often more than average, so the same person can need two approaches. And the stress link runs in a particular direction for migraine: attacks often arrive as stress falls, the so-called let-down pattern of weekend and holiday migraines.

If you suspect migraine, the practical next step is not a different home remedy but a diagnosis. Readers asking “what can I do to help with migraines” deserve a migraine-specific answer from a clinician, because the preventive and acute options differ substantially and some are prescription-only. The non-drug measures in this article, particularly regular sleep, exercise, relaxation training and biofeedback, do carry evidence for migraine as well, so they are rarely wasted effort.

Episodic or chronic: why counting headache days matters more than counting painkillers

If there is one number worth tracking, it is headache days per month. ICHD-3 divides tension-type headache by frequency, and the divisions are not bureaucratic; they predict how the condition behaves and what tends to help.

Infrequent episodic tension-type headache means fewer than one headache day a month on average. Frequent episodic means one to fourteen days a month for more than three months. Chronic means fifteen or more days a month, again for more than three months. Most people sit in the first two categories and will never need more than occasional self-care. The chronic group is smaller, perhaps 2 to 3 percent of adults by most estimates, and carries most of the disability.

The thresholds matter because chronic tension-type headache is where central sensitization takes hold, where anxiety and low mood co-occur more often, and where medication-overuse headache becomes a real risk. Crossing from twelve headache days to sixteen is not a small change in a diary; it is a change in the kind of problem you have, and usually a cue for a clinician-led prevention plan rather than more of the same.

This is why a headache diary is, in our view, the most underrated tool in the whole field. Note the date, roughly how long the headache lasted, its intensity on a simple scale, what preceded it (sleep, meals, caffeine, deadlines, screen hours, neck strain), and whether you took any medicine. Four weeks of entries will tell you more than any single consultation, and clinicians consistently say a filled diary is the most useful thing a patient brings.

Paper or phone, it does not matter. What matters is that the pattern you think you have and the pattern you actually have are often different, and only the written record settles it.

What the evidence actually says about non-drug approaches

Evidence comes in grades, and the grade should shape your expectations. Randomized controlled trials (studies that assign people by chance to a treatment or a comparison) are the strongest. Observational studies track what people already do and are prone to bias. Expert opinion is a considered judgment where trials are absent. Here is how the main non-drug approaches to tension-type headache stack up.

Approach	Best evidence available	What it shows	Strength
Acupuncture	Cochrane review, 12 RCTs, 2,349 people (2016)	Modest reduction in headache frequency versus sham; larger versus usual care	Moderate
EMG biofeedback	Meta-analyses of RCTs	Medium to large reductions in headache activity; effects persisted at follow-up	Moderate, but trials small and older
Relaxation training and CBT	Multiple RCTs, mostly small	Fewer headache days; benefit adds to preventive medicine	Moderate to low
Physical therapy, exercise, manual therapy	Small RCTs	Some reduction in frequency and tenderness; inconsistent across trials	Low to moderate
Massage	Small RCTs	Short-term relief reported; few quality trials	Low
Mindfulness-based programs	Early RCTs	Promising for chronic forms; data still thin	Low
Spinal manipulation	Small, mixed RCTs	No consistent benefit shown	Low
Heat, cold, hydration, posture, rest	Expert opinion	Widely recommended; untested in trials	Expert opinion

Two patterns stand out. The approaches with the best data are the ones that work on the nervous system’s response to stress, not the ones that press, crack or stretch a single structure. And the “boring” lifestyle measures are not disproven; they are simply unproven, because nobody funds a trial of drinking water. That is a different, and more forgiving, kind of uncertainty.

How to relieve tension headache in the moment: what to try first

When a stress headache is building at three in the afternoon, you want something that works in the next hour, not over eight weeks. Almost everything in this category rests on expert opinion and clinical experience rather than trials, and we will say so plainly. It is still sensible, low-risk, and recommended by Mayo Clinic, the NHS and MedlinePlus alike.

Start by changing state. Step away from the screen, stand up, and let your shoulders drop; most people discover they have been holding them near their ears. Slow your breathing for two or three minutes, lengthening the out-breath. This is the kernel of the relaxation training that does have trial support, applied in miniature.

Apply temperature. Warmth on the back of the neck and shoulders eases the muscle tenderness that marks tension-type headache; a warm shower does the same job. Some people prefer a cool pack on the forehead or temples. Neither has been trialled head to head, and the right one is whichever you reach for twice.

Move gently. Slow neck rotations, chin tucks and shoulder rolls, held without force, address the pericranial tenderness directly. The viral thirty-second pressure release has not been tested; pressing the tender spots at the base of the skull is unlikely to harm you and may feel good, but treat it as comfort, not cure-all claims of a reset.

Check the basics. Have you eaten? Had water? Skipped your usual coffee? A missed meal or caffeine withdrawal is a frequent, fixable culprit. Then, if you can, a short walk in daylight; the combination of movement, distraction and a change of scene is what most people describe as the moment the headache “let go.”

Medicines have their place, and the next-but-one section covers them, including the one trap that turns an occasional headache into a daily one.

Headache from stress and anxiety: does treating the stress treat the headache?

For many readers the real question behind “headache from stress and anxiety” is whether working on the mind can genuinely change the head. The evidence says yes, with moderate confidence and realistic effect sizes.

Three psychological approaches have been studied in randomized trials. Relaxation training teaches progressive muscle relaxation (systematically tensing and releasing muscle groups) and paced breathing. Cognitive behavioral therapy, or CBT, is a structured talking therapy that targets the thought patterns and habits that amplify stress. Biofeedback uses sensors to show you, in real time, your muscle tension or skin temperature so you can learn to lower it; the electromyographic (EMG) version, which measures muscle activity in the forehead or neck, is the form with the most headache data.

Meta-analyses of EMG biofeedback trials report medium to large reductions in headache frequency and intensity, with gains holding at follow-up months later. The caveat is that many of those trials date from the 1980s and 1990s and enrolled small numbers, so the grade is moderate rather than high. Relaxation training and CBT show smaller but consistent effects across a similar body of evidence.

One well-designed randomized trial in chronic tension-type headache compared stress-management therapy, a preventive medicine, both together, and placebo. The combination helped the largest share of people achieve a meaningful reduction in headache, more than either approach alone. That finding is the best argument for not framing this as medicine versus mindset.

Why would this work biologically? Chronic headache is partly a problem of a sensitized nervous system, and these techniques lower baseline arousal, improve sleep and reduce the clenching and guarding that feed pericranial tenderness. People with chronic tension-type headache also have higher rates of anxiety and depression, and treating those conditions reduces overall burden even when headache days fall only modestly.

Access varies, and some programs are now delivered online or by app with early supportive data. Whether a formal program is right for you is a decision to make with your clinician, who can also check that anxiety or low mood is not the larger problem hiding behind the headache.

Exercise, posture, neck strain, sleep and caffeine: what helps and what is overstated

Lifestyle advice for stress headaches tends to be delivered with more confidence than the evidence supports, so here is the graded version.

Regular aerobic exercise has the best footing. Small randomized trials in tension-type headache, and larger ones in migraine, show fewer headache days with a steady program of brisk walking, cycling or swimming over several weeks. Exercise raises pain thresholds, improves sleep and dampens the stress response; the mechanism is plausible and the direction of effect is consistent even if the trials are modest.

Physical therapy aimed at the neck and shoulders, including targeted strengthening and stretching, reduces pericranial tenderness in some trials and headache frequency in fewer. The evidence is low to moderate and inconsistent. It is reasonable, particularly if your examination shows a stiff or weak neck, but it is not a universal fix.

Posture is the most overstated factor. “Text neck” makes an appealing story, yet studies linking screen posture to headache are observational and mixed. Changing position often, raising your screen to eye level and taking short movement breaks are sensible on ergonomic grounds; expect them to help some people somewhat.

Sleep is underrated in the other direction. Both too little and irregular sleep are well-documented precipitants, and chronic tension-type headache and insomnia feed each other. A consistent wake time does more for most people than any pillow.

Caffeine cuts both ways. A regular intake that suddenly stops produces a withdrawal headache within a day or so, which is why weekend and holiday headaches are common in heavy weekday coffee drinkers. Keeping intake steady, or tapering gradually if you want to reduce it, prevents the swing.

Two further contributors deserve a mention: jaw clenching and tooth grinding, which can present as morning headache and tender jaw muscles, and uncorrected vision, which produces end-of-day forehead pain. A dentist and an optometrist, respectively, can rule them in or out.

Acupuncture for stress headaches: the Cochrane verdict

Acupuncture is the non-drug approach for tension-type headache with the largest body of randomized evidence, and the 2016 Cochrane review is the fairest summary of it. Cochrane reviews are independent syntheses of trials that grade the certainty of their own conclusions, which makes them a useful anchor when claims run ahead of data.

The review pooled 12 randomized trials and 2,349 participants with frequent episodic or chronic tension-type headache, each receiving a course of at least six acupuncture sessions. Two comparisons tell the story.

Against sham acupuncture (needles placed superficially or at non-acupuncture points, so participants cannot tell the difference), 51 percent of people receiving real acupuncture had at least a halving of their headache frequency, compared with 41 percent of those receiving sham. That ten-point gap is statistically robust and clinically modest; the authors rated the evidence moderate quality.

Against usual care or treatment of acute headaches only, the gap was far wider: in two trials, 48 percent of acupuncture recipients achieved that halving versus 17 percent of controls. Part of that difference is the specific effect of needling and part is the non-specific effect of attending a course of treatment, being touched and being heard. The sham comparison is what separates the two, and it shows the specific effect is real but small.

Adverse effects were minor and short-lived, chiefly bruising or brief soreness. Benefits were largely maintained at six months in the trials that followed people that long.

How should you read this? Acupuncture is a reasonable option for frequent stress headaches, with evidence stronger than most alternatives and weaker than the enthusiasm sometimes attached to it. It is not a one-visit fix; the trials used courses of several weeks. As with every approach here, it belongs in a plan agreed with the clinician who knows your history, not as a substitute for a diagnosis.

What is the best medicine for a headache? Where medicines fit, and the overuse trap

Readers ask what the best medicine for a headache is more than any other question, and the honest answer has two halves: which medicines are used, and the one way they turn against you.

For occasional tension-type headache, mainstream guidance from Mayo Clinic, the NHS and MedlinePlus points to over-the-counter pain relievers: acetaminophen (called paracetamol outside the United States), and the anti-inflammatories ibuprofen, aspirin and naproxen. Some products add caffeine, which modestly boosts effect in trials. Randomized trials show each beats placebo for a single attack; the differences between them are small, and the right choice depends on your other conditions, your stomach, your kidneys and your other medicines. That is a conversation for a pharmacist or doctor, not a ranking.

For frequent or chronic tension-type headache, clinicians sometimes prescribe a daily preventive. The most studied is amitriptyline, a tricyclic antidepressant used here at the level of pain prevention rather than mood, with moderate trial evidence for fewer headache days. Other options exist, and the decision, the choice and any change belong entirely to the prescribing clinician.

Now the trap. Medication-overuse headache is a secondary headache caused by regular, frequent use of pain relievers for a primary headache. The NHS and Mayo Clinic both warn that taking them on more than a couple of days a week, week after week, can convert occasional headaches into a near-daily one that the same tablets no longer relieve. It is one of the commonest reasons an episodic problem becomes chronic, and it is reversible under medical supervision, though withdrawal headaches can be uncomfortable for a time.

If your diary shows pain relievers on most days, do not stop them abruptly on your own and do not simply switch products; see a clinician. This is precisely the situation where the non-drug approaches in this article stop being optional extras and become the main plan.

Common myths about stress headaches

Viral health content thrives on single causes and instant fixes. Tension-type headache offers neither, which is why so many claims about it need correcting.

“It’s a cortisol headache.” No classification recognizes this entity, and no study shows cortisol directly causing head pain. Stress works through muscle activity, sleep, clenching and pain thresholds. Cortisol is a bystander in the story, not the author.

“Press this spot for thirty seconds and release it.” Untested. Pressing tender muscles at the base of the skull is a comfort measure that has never been compared with doing nothing, and the people demonstrating it on camera were not blinded to what they expected.

“It’s all tight muscles.” Only partly. Muscle tenderness is real, but measured muscle activity is at most modestly raised, and the chronic form is driven by a sensitized nervous system. That is why rubbing harder does not scale.

“A headache means my blood pressure is high.” Usually not. Ordinary high blood pressure is silent; headache is a feature only at dangerously high readings, which come with other warning signs.

“It’s a sinus headache.” Most self-diagnosed sinus headaches turn out to be migraine or tension-type headache. True sinus pain comes with infection: thick discharge, fever, facial tenderness.

“Painkillers are harmless if they’re over the counter.” Taken often enough, they can cause the very headaches they treat. See the section above.

“Phones and posture cause everyone’s headache.” The evidence is observational and mixed. Movement breaks are sensible; blaming the phone for a chronic daily headache can delay a real assessment.

“Daily headache is just stress; nothing can be done.” Chronic tension-type headache has moderate-quality evidence for several treatments, and medication overuse, sleep disorders and mood disorders that often sit behind it are all addressable. Resignation is the one approach with no evidence at all.

When to see a doctor about stress headaches: red flags and quieter reasons

Most stress headaches are benign and most people manage them without a visit. The exceptions are not subtle, and they are worth memorizing. Seek emergency care, or call emergency services, for any of the following:

• A sudden, severe headache that peaks within seconds to a minute, often described as the worst of your life (a “thunderclap” headache).
• Headache with fever, a stiff neck, a rash, confusion or a seizure.
• Headache with weakness or numbness on one side, drooping of the face, slurred speech, loss of vision or double vision, or trouble walking.
• Headache after a blow to the head, especially with vomiting, drowsiness or worsening pain.
• A headache that wakes you from sleep, is worse on lying down, or is triggered by coughing, straining or bending.

Make a routine appointment, sooner rather than later, if headaches are new after age 50, are steadily worsening over weeks, have changed character from your usual pattern, began during pregnancy or soon after childbirth, or coincide with starting a new medicine. Book too if you are having headaches on 15 or more days a month, if you are taking pain relievers on most days, if headaches are affecting work, sleep or mood, or if home measures that used to work have stopped working. Anyone with a weakened immune system or a history of cancer should have a new headache assessed.

What happens at the visit is reassuringly ordinary. A clinician takes a detailed history (your diary earns its keep here), examines your nervous system, checks blood pressure and presses the muscles of the head and neck. When the history is typical and the examination normal, imaging is usually not needed; scans are reserved for red flags.

Every decision about medicines, starting, changing or stopping them, belongs to the clinician who examines you. The non-drug approaches in this article are designed to sit alongside that relationship, not replace it.

Frequently asked questions

Why does my head hurt when I'm stressed?

Stress raises muscle activity in the neck, jaw and scalp, disrupts sleep, encourages clenching and lowers pain thresholds, and together these produce the pressing, two-sided pain of tension-type headache. Tender pericranial muscles are the most consistent physical finding. In long-standing cases the nervous system itself becomes more sensitive to pain signals. No single hormone, including cortisol, has been shown to cause the headache directly.

What are the main tension type headache symptoms?

A dull, band-like pressure on both sides of the head, mild to moderate in intensity, that does not throb and is not worsened by walking or climbing stairs. There is no vomiting and no aura, though mild sensitivity to light or sound (not both) can occur. Scalp and shoulder muscles may feel tender. Attacks last from 30 minutes to several days and often build through the afternoon.

What is the difference between a stress headache vs migraine?

Migraine is usually one-sided, throbbing, moderate to severe, worse with movement and accompanied by nausea and sensitivity to both light and sound, sometimes preceded by aura. Tension-type headache is the opposite on almost every point: both sides, pressing, milder, unaffected by activity, no vomiting. Stress triggers both, which is why the labels get confused. If you suspect migraine, a clinician’s diagnosis opens migraine-specific options.

How can I relieve a tension headache quickly without medicine?

Step away from the screen, drop your shoulders, slow your breathing for a few minutes, and apply warmth to the neck and shoulders or a cool pack to the forehead. Gentle neck rotations, a drink of water, a missed meal eaten and a short walk in daylight help many people. These measures rest on expert opinion rather than trials, but they are low-risk and widely recommended.

What is the best medicine for a headache?

For occasional tension-type headache, mainstream guidance points to over-the-counter pain relievers such as acetaminophen, ibuprofen, aspirin or naproxen, which all beat placebo in trials with small differences between them. The right one depends on your health conditions and other medicines, so ask a pharmacist or doctor. Frequent use on more than a couple of days a week risks medication-overuse headache, and preventive prescriptions are a clinician’s decision.

What are some ways to treat a headache long term?

For frequent stress headaches, the approaches with randomized-trial evidence are acupuncture, EMG biofeedback, relaxation training and cognitive behavioral therapy, alongside regular aerobic exercise and consistent sleep. A headache diary identifies triggers and tracks headache days. Clinicians may add a preventive medicine, and one trial showed stress-management therapy plus medicine outperformed either alone. The plan should be agreed with your clinician.

What can I do to help with migraines if my headaches turn out not to be stress headaches?

First get a diagnosis, because migraine has specific acute and preventive treatments that a clinician can match to you. Non-drug measures that carry evidence for migraine include regular sleep and meals, steady caffeine intake, aerobic exercise, relaxation training and biofeedback, and keeping a diary to spot triggers. Avoid frequent pain-reliever use, which causes medication-overuse headache in migraine just as in tension-type headache.

Can anxiety cause a headache from stress and anxiety every day?

Anxiety is strongly associated with chronic tension-type headache and can drive the muscle tension, poor sleep and heightened pain sensitivity that keep headaches going day after day. Daily headache can also signal medication overuse or a sleep disorder, so it should be assessed by a clinician rather than attributed to anxiety alone. Treating anxiety with CBT or relaxation training often reduces headache burden.

Does acupuncture really work for stress headaches?

Moderately, according to a 2016 Cochrane review of 12 randomized trials with 2,349 participants. After a course of at least six sessions, 51 percent of people receiving acupuncture at least halved their headache frequency, compared with 41 percent receiving sham needling and 17 percent receiving usual care. Side effects were minor. It is a reasonable option for frequent headaches, not a single-visit fix.

When should I worry about a headache and see a doctor?

Seek emergency care for a sudden severe headache peaking within a minute, headache with fever and stiff neck, confusion, weakness, numbness, slurred speech, vision loss, or headache after a head injury. See a doctor soon for headaches that are new after 50, steadily worsening, different from your usual pattern, occurring 15 or more days a month, or if you take pain relievers on most days.

References

• Tension headaches (NHS)
• Tension headache (MedlinePlus Medical Encyclopedia)
• Headache disorders fact sheet (WHO)
• Tension Headache, StatPearls (NIH National Library of Medicine)

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.