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Current theories on the cause of tension-type headache associate it with muscle contractions of the scalp, neck and temples. The contractions are involuntary but constant. Muscle contractions produce lactic acid, a chemical substance released into the bloodstream by the muscles upon exertion. Increased levels of lactic acid lead to a state of cell toxicity. Muscle stiffness can affect other structures of the head and neck, cause inflammation of nerve roots, or change the vertebral alignment in the spinal column. All of these conditions increase pain and discomfort.
Involuntary muscle contraction can be triggered by several factors, including:
- Stress. Stress is one of the principal causes of tension headache. Emotional factors such as anxiety or depression can bring on a tension headache. A stressed person tends to transfer the pent up strain and tension by involuntarily contracting head and neck muscles.
- Posture. Maintaining the same body position, especially if incorrect, can lead to muscle contraction and pain. In women, the trapezoid muscles of the shoulders are smaller than they are in men, so the head tends to lean forward. To maintain an upright head position, women put more tension on their head and neck muscles.
- Malocclusion. Poor fit of the upper and lower teeth produces dysfunction of the temporomandibular joint (the joint on the side of the jaw). This leads to tension in the neck muscles and those used for chewing.
- Overuse of medications. The use of too many pain relievers can produce an addiction to the active ingredient they contain. This "rebound effect" reduces the effectiveness of the drug, so that the pain becomes chronic.
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