Tension headache - when the head is under pressure

How physiotherapy and occupational therapy can provide lasting help

Dull pressure, pulling pain from the neck to the forehead, the feeling of a tight belt around the head - tension headaches are one of the most common forms of pain. They often start insidiously, are distressing but rarely alarming - and are therefore often underestimated. However, there is often more to tension headaches than just a tense neck. The good news is that with targeted physiotherapy, occupational therapy support and a holistic approach, the symptoms can be effectively alleviated and the frequency significantly reduced.

What is a tension headache?

Tension headaches belong to the group of primary headaches - i.e. pain without a recognizable organic cause. It can occur episodically (occasionally) or chronically (more than 15 days a month).

Typical features:

  • Dull, pressing or pulling pain ("like a band around the head")

  • bilateral, usually in the forehead, back of the head or neck area

  • No nausea, no vomiting, but often sensitivity to light or noise

  • Reinforcement in case of stress, fatigue, muscle tension

  • Frequent companions: jaw problems, eye strain, lack of exercise

Important: Tension headaches are benign - but if they become chronic, they have a severe impact on everyday life, concentration and quality of life.

Causes - an interplay of body and psyche

Tension headaches do not just occur "in the neck". It is a complex interplay of:

  • muscular imbalances (especially neck, jaw, shoulder girdle)

  • Vegetative overload (e.g. in the case of constant stress or lack of sleep)

  • Poor posture, screen work, lack of exercise

  • Mental stress (e.g. due to pressure, worries, emotional tension)

  • sensorimotor dysregulation and central pain processing

That is why no "simple solution" helps - but an individual, multimodal therapy approach.

Physiotherapy - relieve, mobilize, regulate

Physiotherapy for tension headaches is not just about massage or muscle relaxation. It is crucial to recognize functional correlations, improve posture and calm the nervous system in a targeted manner.

Therapeutic focus:

  • Manual techniques in the cervical spine, jaw and shoulder girdle area

  • Breathing and relaxation techniques for vegetative regulation

  • Posture training & ergonomic movement patterns

  • Strengthening the deep core and neck muscles

  • Medical yoga for mobilization, awareness and stress reduction

The aim is to reduce the physical causes without creating new stimuli - and to calm the system.

Occupational therapy - making everyday life less stressful

With chronic tension headaches in particular, everyday life is often full of stimuli, excessive demands and unfavorable routines. Occupational therapy helps to make lasting changes to behavioral patterns, workplace conditions and stimulus management.

Occupational therapy approaches:

  • Analysis and adaptation of workstations (e.g. screen height, sitting position)

  • Pacing and stress management in everyday life

  • Training in relaxation techniques and stress management

  • Time management, break organization and stimulus reduction

  • Cognitive strategies for coping with pain and confidence in action

Particularly effective: combination of educational talks, body-oriented techniques and functional everyday training.

Think holistically - recognize tension, interrupt patterns

At Hockenholz, we do not look at tension headaches in isolation, but as an expression of a dysregulated system. The causes often lie in the body as well as in the mind, in behavior and in unconscious patterns of tension.

Our therapeutic approaches include:

  • Pain education: How does a tension headache really develop?

  • Vegetative regulation: calming the nervous system instead of just treating symptoms

  • Resource activation: movement, breathing, self-care

  • Interdisciplinary cooperation: e.g. with dentists, neurologists, psychologists

Conclusion: Tension headaches are treatable - if we understand them

Tension headaches are unpleasant, but they are not destiny. With an individually tailored combination of physiotherapy, occupational therapy, behavioral adjustment and bodywork, triggers can be defused, symptoms alleviated and relapses avoided. The key is not to quickly push them away - but to consciously relieve them.

Are you a therapist and want to learn how to provide holistic support for people with tension headaches?
Then discover our practical training courses on pain physiology, autonomic regulation and functional movement:
👉 www.hockenholz.com/weiterbildungen

Are you affected yourself?
We will accompany you attentively, professionally and individually - in our practice in Berlin or online.

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Chronic pain - understanding, accompanying, changing