Although by no means the commonest, headache is still one of the symptoms which often take people to see their doctors. Even then research suggests that this is just the tip of the iceberg with many people treating themselves with over-the-counter remedies or just suffering in silence.

The causes of headaches are numerous and thankfully not medically serious in the majority of cases. Some are clearly defined in terms of cause, symptoms and treatment such as sinusitis and some migraine. For many people, the nature of their headache is less easy to track down. When a clear cause cannot be defines, the label "tension-type headache" is used.

Tension–type headaches are extremely common with up to three quarters of the adult population experiencing symptoms at some point in their life. The headaches are typically described as a tightness, sometimes in the forehead, sometimes at the back of the head. For most people, the symptoms are short-lived. For a minority, they may occur on a near daily basis.

Causes are extremely variable. For some the root of the problem is purely physical, typically involving the neck muscles which may be found to be in tender spasm. For others, there may be emotional and psychological factors involved – stress, depression and anxiety. For a small number of sufferers, the long-term use of painkillers such as codeine may be implicated as part of the cause. Over-use of caffeine and alcohol may also be responsible.

The best approach to take in tackling tension-like headache is to treat the underlying cause, though in the case of emotional upset, this may be rather easier said than done. Changes in lifestyle such as cutting down alcohol, caffeine and painkillers may help for some. Reducing stress should be undertaken whenever possible. Taking up some gentle exercise can help as can giving attention to getting a good night’s sleep. Some find relaxation techniques useful, for others, neck spasm may respond to massage. Drug treatment has its place, both simple over-the-counter remedies for short-term relief and prescription medicines. The latter may be particularly useful in the treatment of underlying muscular problems or treating depression. Some anti-depressants seem to help the headache independently of their anti-depressant effect.

For tension-like headaches which don’t respond to standard measures, it may be worth seeking medical help to try different measures or exclude other causes.