What causes tension-type headaches?

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Some, but not all, may be due to tension. The term 'tension-like headache' is now used rather than 'tension headache' as the cause is often not clear. Many tension-type headaches develop for no apparent reason. Other causes include the following.

Emotional tension, anxiety, or stress may cause some headaches.
Physical tension in the muscles of the scalp and neck may lead to a headache. For example, poor posture at a desk may cause the neck and scalp muscles to tense. If you squint to read because you cannot see well, this may tense your scalp muscles too.
Something may trigger a tension-type headache. For example: a food, bright sunlight, illness, a side-effect of medication, depression, cold, heat, tiredness, noise, caffeine, etc.

Note: painkillers that you may take regularly can sometimes cause headaches similar to tension-type headaches. For example, you may take a lot of painkillers for a bad spell of headaches. You may end up using painkillers every day, or on most days. Your body then becomes used to painkillers. A 'withdrawal' headache then develops if you do not take painkillers each day. (This is called 'medication headache'. A separate leaflet discusses this further.)

What are the symptoms of a tension-type headache?

Typically, the pain is like a tightness around the 'hat-band' area. Some people feel a 'squeezing' or 'pressure' on their head. It usually occurs on both sides of your head, and often spreads down your neck, or seems to come from your neck. Sometimes it is just on one side. The pain is usually moderate or mild, but sometimes it can be severe.
A tension-type headache can last from 30 minutes to 7 days. Most last a few hours or so.
The headache normally comes on during the day, and gets worse as the day goes on.
There are usually no other symptoms. Some people don't like bright lights or loud noises, and don't feel like eating much when they have a tension-type headache.