Tension-type headache and migraine causes
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
Migraines on the other hand, are severe and disabling attacks that reoccur over time and are 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 often experience seeing spots or stars during attacks and may feel fatigued or dizzy after.2,3
Pathophysiology, causes and triggers of tension-type headaches
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.
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Causes of tension-type headaches 5
TTH are caused by either factors related to increased stress and/or problems with the neck muscles.
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Tension-type headache triggers5
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.
Pathophysiology, causes and triggers of migraines
Pathophysiology of migraines6
Migraines are caused when the nerves and blood vessels around the trigeminal nerve (trigeminovascular system) located in the head are triggered to fire abnormally. When this happens, the trigeminal nerves produce and release substances called vasoactive neuropeptides, prostaglandins and inflammatory cytokines.
Upon release, these substances cause inflammation of the surrounding blood vessels, which in turn activates the pain receptors nearby (nociceptors). When nociceptors are activated, these sensory nerves send signals to parts of the brain responsible for producing the sensation of pain such as the thalamus and cerebral cortex.
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Causes of migraines3,4
Migraines are thought to have a genetic basis with environmental factors playing a significant role in how it affects migraine sufferers.
In fact, if one parent has migraine, there is a 50% chance of a child having it too, and if both parents suffer from migraines then the risk of their child developing migraines increases to 75%.
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Migraine triggers2,6
Migraine triggers can be classified into different factors such as:
Factors Triggers Emotional Stress and anxiety Physical Poor sleep, menstruation, hormonal changes, lack of exercise, dehydration Dietary Red wine, fasting or skipping meals, artificial sweeteners, monosodium glutamate (MSG) Environmental Changes in weather, flickering light Medicines Drugs that cause vasodilatation (nitrates), oral contraceptives.
Understanding headaches and migraine
Headaches & migraine overview
Find out more about how headaches and migraines impact people’s life.
How do they present?
Find out the signs and symptoms of tension-type headache and migraine. Learn to differentiate them and learn about “red flag” symptoms that indicate a referral to a doctor.
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 and migraine.
Learn more
Combination of paracetamol and caffeine for tension-type headache
Discover how paracetamol and caffeine work together to help treat pains like tension-type headaches.
