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Tension Headaches

 by: Joe Hing Kwok Chu


Until recently tension headaches were erroneously deemed to be caused by:

  • (a) tension of the muscles in the face, neck and shoulders or

  • (b) depression or

  • (c) stress.

The term "tension headache" has been replaced by "tension type of headaches."  These headaches are not caused by tension of those muscles nor by depression nor by stress.


Tension type of headaches, muscle tensions, depression, and inability to handle stressful situations are all manifestations of a common cause. They are mainly caused by the imbalance of serotonin, epinephrine, norepinephrine and endorphins.


Serotonin, epinephrine, norepinephrine and endorphins are neurotransmitters that transmit nerve signals between the synapses (junctions) of nerve cells. When serotonin and/or norepinephrine are low, histamine is being released. The releasing of histamine causes the blood vessels to dilate and the muscles to tighten. Tightening of the muscles is the result of serotonin depletion. The dilation of the blood vessels in certain locations in the brain thus leads to headaches by pressing on nerves and causing pain.


If the endorphin level is low, the headaches become more severe since endorphins possess pain relieving properties similar to morphine. When norepinephrine is low, the heart rate is low, thus creating a condition to increase the chance for platelets to coagulate. When epinephrine is too high, the blood vessels become tight, which also increases the chances for platelets to coagulate.


The depletion of serotonin also increases the inability to handle excessive information, thus creating more stress and leading to depression.


Circulation dysfunction often results in serotonin depletion. Platelet coagulation due to sluggish circulation creates the leaching out of serotonin from the platelets.


Warning: Mistreatment or misdiagnosis of circulation problems can lead to serious consequences such as blood clots, which may result in heart attack or stroke. 


Therapy Methods


Drug Therapy

Over the counter analgesic pills such as aspirin, acetaminophen, or ibuprofen can provide temporary relief of headaches.

Tension type headaches usually are treated like migraines with tricyclic antidepression drugs.

Amitriptyline is effective against chronic tension type headaches but typically creates side effects such as weight gain (due to increased appetite) and drowsiness.

Nortriptyline, closely related to amitriptyline, is also effective without the side effect of weight gain, though some people experience drowsiness.  Protriptyline, comparable in effectiveness to Amitriptyline, does not typically have side effects of drowsiness and weight gain.

Dextroamphetamine is being used for those do not respond well to tricyclics.

The Selective Serotonin Reuptake Inhibitors, such as fluoxetine (Prozac), paroxitine (Paxil) and sertraline (Zoloft) are also being used although the effectiveness is not proven.

Beta-blockers such as propanolol and atenolol are being used as preventive medication, but they create the side effect of erectile dysfunction.


Warning: Using drugs on a trial and error method to treat this type of headache without understanding the functioning of the individual person's body can create serious harm or injury.

Also, most of these drugs can create serious side effects.



Various types of massage can also provide temporary relief of headaches but do not solve the problem permanently.


Stretching Exercises

Various stretching exercises can provide temporary relief of headaches but do not solve the problem permanently.


Diet Therapy

Eat smaller portions and more frequently to keep the blood sugar balance.

Avoiding certain food can help prevent headaches. See migraine food.


Herb Therapy

Use traditional Chinese medicine diagnostics to prescribe herb therapy:

Acupuncture Therapy


Qigong (chi kung) Therapy

Certain qigong therapy and qigong exercises can help prevent migraine.


Qigong with Gua Sha Treatments



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Last update: Mar 12, 2009,  2:07 p.m. LAH