Tension Headaches

Neuromuscular Dentist in Chicago, IL Accepting Patients Nationwide & Worldwide

Everybody suffers from headaches at times. The most common is the tension headache. The pain of a tension headache is usually diffuse across the entire head, not sharp or local to one area. While it may feel like a tension headache is caused by stress from muscles, many doctors do not think that is the actual cause and classify it as a tension headache. In reality, these headaches usually have multiple causative factors of which muscle is only a part of the picture.

Tension headaches are often related to TMJ disorders and jaw function as well as poor (forward) head posture. A primary function of normal jaw position is to maintain head posture and balance.

All patients diagnosed with tension headaches, chronic daily headaches, or morning headaches should consider evaluation by a neuromuscular dentist.  


A tension headache can last anywhere from 30 minutes to several days. Symptoms include:

  • Dull aching pain
  • Dull aching pain is characteristic of referred muscle pain
  • Tightness across forehead
  • Sore muscles

Sore muscles of the head and neck are one of the hallmark signs of temporomandibular disorders. (TMJ, TMD, TMJD)

Tension headaches are classified in one of two ways:

  • Episodic – If the headache occurs less than 15 days per month, it is considered episodic, even if it is very frequent or long lasting.
  • Chronic – Headaches that occur more than 15 days out of one month are classified as chronic. These are often called chronic daily headaches.

Both chronic and episodic varieties are often related to jaw function and can be helped by diagnosis and treatment modalities of neuromuscular dentistry.

Sometimes, tension headaches are confused with migraines, but there are usually no other factors like visual problems, nausea, and other symptoms relating to migraines.

Tension headaches and migraines are often related and one can serve as a trigger of the other. They can often present simultaneously.


Some studies indicate that the long held belief of muscle contractions of the head and neck caused headaches is erroneous. Many dentists now believe that tension headaches are caused by fluctuations in the certain chemicals in the brain including serotonin and endorphins. The underlying reasons for the changes in the chemical levels, however, remain a partially understood mystery.

The brain is actually the mainframe computer for the body and the chemical transmitters are controlled within the brain but also by the nervous input to the brain from the body. Many problems are similar to computer phrase garbage in/garbage out. Noxious stimuli can activate the central nervous system causing central sensitization that can result in hyperalgesia where pain is magnified in the brain or allodynia where normally non-painful stimuli provoke pain.

There are several other factors that appear to trigger tension headaches, including:

  • Stress 
  • Often precipitating grinding of the teeth and/or clenching of jaw muscles and/or tightening neck and shoulder muscles.
  • Depression
  • Hard work (type A personalities tend to get headaches when work levels drop or they are on vacation)
  • Bruxism (grinding f the teeth or clenching the jaw often done unconsciously or during sleep)
  • Poor posture
  • Sleep disturbances of shifts in sleep cycles

Interestingly, posture and stress are both related to jaw function. An over-closed or posteriorally displaced bite will result in poor head posture. Forward head posture can make muscles all the way to the low back work harder just to hold the head up. For every centimeter of forward head posture the muscles all the way to the low back work twice as hard to maintain posture. A four centimeter forward head posture would increase muscle activity 16 fold.


Although in many cases, tension headaches resolve spontaneously after a relatively short period of time, there are some ways to treat the headache to reduce the pain and minimize the duration. Headache treatment usually is done with medication or therapy.


The traditional treatment for tension headaches is through medication. Frequently, over the counter pain medications are used to alleviate the symptoms. If you are currently taking other medications, you will want to check with your dentist before you self medicate when a headache occurs. Common over the counter (OTC) medications include:

  • Aspirin
  • Acetaminophen
  • Ibuprofen

The use of Self-Administered Sphenopalatine Ganglion (SPG) Blocks can be a game changer for patients with chronic tension headaches.  The Blocks have a 100 year + safety record and utilize Lidocaine.  SPG Blocks can turn off Anxiety and reduce the bodies reaction to chronic stress.  Dr Shapira published a paper in May 2019 in CRANIO Journal on the use of SPG Blocks and Neuromuscular Dentistry to eliminate pain and anxiety.


Many people are choosing alternatives to medication either because they are taking other medications that may interact, or simply want to use more homeopathic treatment methods. Some of the alternative therapies include:

  • Stress management
  • Muscle relaxation exercises
  • Oral appliances
  • Paying more attention to posture
  • Acupuncture
  • Massage therapy

Neuromuscular dentistry utilizing orthotics is one of the most effective treatments for tension headaches. The use of TENS to relax muscles and an orthotic (oral appliance) to maintain the relaxed jaw position is extremely effective. These headaches are often caused by trigger points in taut muscle bands (Travell) and can be treated with spray and stretch techniques utilizing vapocoolant sprays and/or trigger point injections.

You should go to your doctor right away if your headache is associated with any of the following conditions:

  • A fever or stiff neck
  • A sudden new onset pain like never before
  • Confusion
  • Problems with speech
  • Seizures
  • Weakness (such as inability to raise arms over head)
  • Head trauma
  • Sudden unexplained numbness or paralysis

Acute onset severe pain may be the first sign of an aneurism or stroke and time is of the essence.

Recent research has shown that head, neck, and facial pain, as well as jaw pain or tooth pain, is often the only symptom (up to 35%) of a heart attack or angina. This pain is frequently an additional symptom or sign in a large percentage of all cardiovascular events.

What to Do about Chronic Tension Headaches

People from all backgrounds and occupations suffer from tension headaches. Women experience them more frequently than men do and headaches seem to increase as you age. If you suffer from frequent tension headaches, or headaches associated with other problems, you should seek medical help right away in order to rule out a more serious underlying condition.

According to a report by the NHLBI, these are the symptoms of temporomandibular disorders along with sleep apnea. Airway problems often are undiagnosed in women and can lead to fatigue, tiredness, and chronic muscle pain as well as headache. It is important to always consider headache as a symptom of an underlying disorder.

Alleviate your pain from tension headaches with treatment at Think Better Life. Contact neuromuscular dentist Dr. Ira L. Shapira by calling 1-847-533-8313 to set up a personalized consultation today!