Chronic Tension Headaches: Causes, Triggers, and What Actually Helps

When you have a chronic tension headache, a persistent, dull ache that feels like a tight band around the head, often linked to muscle tension and stress. Also known as tension-type headache, it’s the most common type of recurring headache—and yet, most people treat it like a minor nuisance instead of a condition that needs real management. Unlike migraines, it doesn’t usually come with nausea or light sensitivity, but that doesn’t make it less disabling. If you’re getting these headaches 15 or more days a month for over three months, you’re dealing with the chronic form—and that’s not normal.

What drives these headaches? It’s rarely just one thing. stress, a major trigger that tightens neck and scalp muscles over time plays a big role, but so do poor posture, jaw clenching, eye strain from screens, and even sleep problems. Many people don’t realize their desk setup or phone habits are keeping their muscles in constant tension. And while over-the-counter painkillers give temporary relief, using them too often can flip the switch to medication-overuse headaches, making the problem worse.

There’s a difference between treating the pain and fixing the root cause. muscle tension, the physical mechanism behind most chronic tension headaches doesn’t vanish with a pill. Physical therapy, targeted stretches, biofeedback, and even cognitive behavioral therapy have shown real results in studies—not just reducing frequency, but helping people regain control. Some find relief with simple changes: adjusting their pillow, taking screen breaks every 20 minutes, or learning to breathe deeper when stressed.

What you won’t find in most advice is the truth about medications. Antidepressants like amitriptyline aren’t just for mood—they’re FDA-approved for preventing these headaches because they affect pain signals in the brain. But they’re not for everyone. And while muscle relaxants might help short-term, they’re not a long-term fix. The real power lies in combining lifestyle changes with the right medical support.

Below, you’ll find real-world insights from people who’ve been there. From how to tell if your headache is tension-based or something else, to which supplements actually help (and which ones are a waste), to what drugs to avoid when you’re already on other meds. These aren’t generic tips. They’re the kind of details that matter when you’ve tried everything and still wake up with that same dull pressure behind your eyes.