A tension headache is a common problem. It generally produces a slight, usually mild to moderate pain over the head. Many people liken the feeling to having a tight band around the head. A tension headache may also result in pain in the back of the neck at the base of the skull. Common symptoms include a headache; tenderness in the scalp, neck and shoulder muscles, insomnia, fatigue, loss of appetite; and difficulty in concentration.

Such a headache is not usually associated with visual or other general disturbances and is not aggravated by activity. The exact cause of tension headache is not known; previously it was considered to be related to muscular tension, and currently, it is believed to be related to changes in the brain neurotransmitters. The duration of a tension headache can be hard to predict, and is potentially triggered by stress, depression, anxiety, lack of sleep, skipped meals, certain medications and hormonal changes, especially in women.

The Ayurvedic treatment of tension headache is aimed at controlling the symptoms, treating the cause, if known, and preventing recurrence. Medicines like Triphala-Guggulu, Yograj-Guggulu, Kaishor-Guggulu, Trayodashang-Guggulu, Nirgundi (Vitex negundo) and Sarpagandha (Rauwolfia serpentina) are used to control the headache. If the headache is usually associated with recurrent sneezing or chronic sinusitis, medicines like Tribhuvan-Kirti, Sitopaladi-Churna, Talisadi-Churna and Yashtimadhuk (Glycerrhiza glabra) are used. If the headache is accompanied by symptoms of hyper-acidity and peptic ulcer, medicines like Laghu-Sutshekhar, Sutshekhar-Ras, Praval-Bhasma, Shankh-Bhasma, Bhunimbadi-Qadha and Praval-Panchamrut are used. An unpredictable type of headache with irregular periodicity is believed to be due to 'Vat' and is treated using medicines like Maha-Vat-Vidhwans-Ras and Bhruhat-Vat-Chintamani-Ras.

Godanti-Bhasma (Purified gypsum) and Sarpagandha form the main stay of treatment for tension headache. Pathyadi-Qadha is a herbal combination which is used on a long term basis to control tension headache and prevent recurrence. In order to treat stress-related factors, medicines like Brahmi (Bacopa monnieri), Jatamansi (Nardostachys jatamansi), Mandukparni (Centella asiatica) are used.

Local applications, usually on the forehead, are also used to treat tension headaches. For the 'Vataj' and 'Kaphaj' types of headaches, a paste of Sunthi (Zinziber officinalis) is applied, while for the 'Pittaj' type, a paste containing Chandan (Santalum album), Yashtimadhuk, Saariva (Hemidesmus indicus) and Usheer (Vetiveria zizanioidis) is used. For headaches which have no apparent cause, application of leeches on the forehead brings about a dramatic relief from pain.

It is important to rule out serious causes of headache before making the diagnosis of tension headache. Adequate lifestyle modifications are required to minimize the known triggering factors for this condition. Regular physical activity like aerobic exercises, yogic asanas and relaxation techniques are very important in controlling and preventing tension headaches.