Has January been giving you a headache?

You’re not alone. In this post, we’ll look at what tension‑type headaches are, how they may be managed, and how we can support you at MH Chiropractic.

What is a tension‑type headache?

Tension‑type headache is the most common primary headache disorder, meaning it is not caused by another underlying condition. It typically presents as pain on one or both sides of the head, often described as a pressing or tightening band‑like sensation. The pain usually ranges from mild to moderate and, for many people, does not completely stop normal day‑to‑day activities.¹ ²

According to the International Classification of Headache Disorders (ICHD‑3), tension‑type headaches are grouped by how often they occur:²

• Infrequent: less than 1 day per month

• Frequent: 10–15 days per month for more than 3 months

• Chronic: 15 or more days per month

The exact cause of tension‑type headache is not fully understood. Current evidence suggests that both peripheral (muscles, soft tissues) and central (brain and spinal cord) pain mechanisms are involved.² ³ Some research suggests that, because it is so common, tension‑type headache may actually account for more missed work overall than migraine.³

How can tension‑type headache be assessed?

Because many different factors can contribute to headaches, an individual assessment is an important first step. This helps to explore potential triggers and, crucially, to exclude other causes that might need medical attention.¹

Some simple questions you can ask yourself include:¹

• Am I drinking enough water across the day?

• Is my last eye test up to date?

• Am I taking regular breaks away from the screen?

For some people, issues such as neck or shoulder pain, high stress levels, low mood or poor sleep may be relevant and may need to be addressed as part of a wider management plan.¹ People with frequent or chronic tension‑type headaches often benefit from a more structured, multi‑factor approach supported by healthcare professionals.¹

Headaches can occasionally be associated with more serious conditions. If your headaches are new, worsening, suddenly severe or different from your usual pattern, or if you have other concerning symptoms (such as fever, rash, confusion, weakness, or visual changes), you should seek timely medical advice from your GP, NHS 111 or emergency services as appropriate.

Evidence‑informed management options

Management of tension‑type headache is individual and should be guided by a thorough assessment and your overall health, preferences and goals.¹ ³ This post does not offer a diagnosis or guarantee of improvement; it summarises some approaches discussed in current literature.

Common elements of care may include:¹ ³

• Education about headache types and triggers

• Lifestyle changes such as stress management, sleep support and regular physical activity

• Reviewing and optimising medication use in discussion with your GP or pharmacist

• Exercise and movement programmes, especially for the neck and shoulder region

Soft‑tissue interventions and dry needling

Research suggests that soft‑tissue techniques (for example, targeted muscle work) and dry needling can reduce pain intensity and headache frequency in some people with tension‑type headache.⁴ These approaches are usually used alongside advice, exercise and other strategies, rather than as stand‑alone “cures”.

Passive joint mobilisation and exercise

There is also evidence that passive joint mobilisation, when combined with exercise, can help reduce headache frequency compared with some forms of usual care.⁵ Again, responses vary from person to person, and these interventions are best considered as part of a broader plan that includes self‑management and, where needed, medical input.⁴ ⁵

It is important that any hands‑on care is clinically justified, tailored to the individual and delivered within current professional standards. In the UK, chiropractors must follow the General Chiropractic Council (GCC) Code and advertising guidance, which means avoiding misleading claims and not suggesting that chiropractic care can prevent or cure all types of headaches.

How MH Chiropractic can support you

At MH Chiropractic, our role is to support you as part of your wider healthcare team, not to replace your GP or other medical specialists. Within that context, we can offer:

• Time to talk
  Space to discuss how your headaches are affecting your daily life, work, activities and sleep.

• An in‑depth musculoskeletal assessment
  A structured examination of your muscles, joints and posture, including screening for signs that might suggest another cause and, when necessary, recommending that you speak to or are referred back to your GP or another appropriate professional.¹

• A personalised management plan
  Where suitable, we may discuss options such as manual therapy, soft‑tissue techniques, dry needling, exercise and lifestyle advice, always tailored to you and your goals. These approaches are not right for everyone, and we will always be clear about what we can and cannot offer and when other services might be more appropriate.⁴ ⁵

Our aim is to work collaboratively with you and, where needed, with other healthcare professionals, supporting evidence‑informed management of musculoskeletal contributors to your symptoms while staying within UK advertising and professional standards.

When to seek medical advice

This blog is for general information only and does not provide a diagnosis or personalised medical advice. Headaches can sometimes be a sign of something more serious. You should seek medical advice promptly if:

• Your headache is new and severe or comes on very suddenly

• Your usual headache changes in pattern, frequency or intensity

• You develop headaches after a head injury

• You experience additional symptoms such as fever, stiff neck, rash, confusion, weakness, speech or vision changes

If you are unsure, it is always safest to contact your GP, NHS 111 or emergency services.

References

1. National Institute for Health and Care Excellence (NICE) (2012, updated 2025). Headaches in over 12s: diagnosis and management (Clinical guideline CG150) – Recommendations, section 1.1 Assessment.

2. International Headache Society (2021). International Classification of Headache Disorders (ICHD‑3): Part I.2. Tension‑type headache (TTH).

3. Scripter C. Headache: Tension‑Type Headache. FP Essent. 2018 Oct;473:17‑20.

4. Kamonseki DH, Lopes EP, van der Meer HA, Calixtre LB. Effectiveness of manual therapy in patients with tension-type headache: a systematic review and meta‑analysis. Disability and Rehabilitation. 2022;44(10):1780–1789.

5. Jung A, Eschke RC, Struss J, Taucher W, Luedtke K. Effectiveness of physiotherapy interventions on headache intensity, frequency, duration and quality of life in patients with tension‑type headache: a systematic review and network meta‑analysis. Cephalalgia.2022;42(9):944–965.