【Common Diseases】Tension-Type Headache (TTH)

💢 Tension Headache Guide (Hong Kong Edition)

Hong Kong lives at a breakneck pace. Overtime, commuting, and high stress levels are now part of the daily routine. Coupled with extended periods spent on computers and looking down at phones, tension headaches have become a common urban ailment. I've personally experienced the intense, "clamping" pain in the back of my head and temples whenever I'm faced with a deadline, often mistaking it for a migraine. However, the causes, pathology, and treatment of tension headaches are completely different.

According to the Hong Kong Hospital Authority and several international medical journals, tension headache is one of the most common types of primary headaches. It is characterized by a bilateral pressure or tightness-like headache and is closely related to stress, muscle tension and posture problems.

1️⃣ Causes and Predisposing Factors (Common in Hong Kong)

Medical professionals believe that tension headaches are related to prolonged tension in the head and neck muscles and abnormal pain processing in the central nervous system . Common triggers in Hong Kong include:

  • Mental stress (work, school, family)
  • Maintaining the same posture for a long time (computer, cell phone, paperwork)
  • Lack of sleep or poor quality sleep
  • Neck and shoulder muscle strain (especially common among office workers and drivers)
  • Vision problems (long-term uncorrected myopia/hyperopia/astigmatism)
  • Bad lifestyle habits (lack of exercise, excessive caffeine intake or withdrawal)

2️⃣ Main symptoms

There are several differences between tension headaches and migraines:

  • Nature of pain : Continuous pressure, tightness (like wearing a tight hat)
  • Location : bilateral temples, forehead, back of the head, and even the entire head
  • Intensity : Mild to moderate, not aggravated by activity
  • Associated symptoms : Generally no nausea or vomiting, a few people may have mild photophobia or phonophobia
  • Duration : 30 minutes to several days

Divided into:

  • Occasional : less than 15 days per month
  • Chronic : ≥15 days per month, lasting for more than 3 months

3️⃣ Medical treatment methods (commonly used in Hong Kong)

🩹 Acute treatment (pain relief)

  • over-the-counter pain relievers
    • Paracetamol
    • Nonsteroidal anti-inflammatory analgesics (NSAIDs, such as ibuprofen and naproxen)
  • Muscle relaxants (prescription required)
    • For excessive tension in the neck and shoulder muscles
  • Warning : Over-reliance on painkillers may lead to medication overuse headache (MOH)

🛡 Preventive treatment (for chronic TTH)

  • antidepressants
    • Tricyclic antidepressants (Amitriptyline) are most commonly used and can reduce the frequency of seizures.
  • physical therapy
    • Neck and shoulder muscle relaxation, posture correction, stretching exercises
  • Psychotherapy
    • Cognitive behavioral therapy (CBT), stress management courses

4️⃣ Non-drug treatment and lifestyle improvement (Editor’s tips)

  • Posture adjustment : Sit upright with the computer screen parallel to your eyes
  • Regular stretching : every 30-45 minutes of work, stretch your neck and shoulders for 2-3 minutes
  • Get enough sleep : have a fixed sleep time and avoid staying up late
  • Deep breathing exercises : can reduce sympathetic nervous system tension
  • Regular exercise : swimming, brisk walking, yoga to relax muscles
  • Vision check : Avoid excessive eye strain
  • Reduce caffeine dependence : Avoid overdose or sudden withdrawal

5️⃣ Common myths among Hong Kong patients

  • "Are tension headaches caused by stress?" ❌
    Stress is a major factor, but posture, muscle tension and sleep quality are also important.
  • “Are painkillers the only solution?” ❌
    Long-term improvement of lifestyle habits, physical therapy and psychological management are the core.
  • "Will constant pain turn into a brain tumor?" ❌
    Most tension headaches are benign, but if they continue to worsen or are accompanied by neurological symptoms, you should seek medical attention immediately to rule out other causes.

6️⃣ Editor’s Summary

Tension headaches are one of the most common types of headaches in Hong Kong. While not as severe as migraines, long-term, recurring attacks can still negatively impact your quality of life. If you experience frequent, "clogging" headaches, especially stiffness in your neck and shoulders, we recommend examining your posture, work habits, and stress levels. See a doctor or physical therapist for an evaluation if necessary. Early intervention can not only reduce headaches but also improve your overall health.

Disclaimer : This article is for reference only and does not constitute any medical advice. The source is referenced from major medical articles.

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