There are many different types of headaches. One of the most common types of headaches are tension-type headaches caused by myofascial trigger points. In other words, tension in the muscles and/or fascia of the head, neck, and upper back will refer pain into different regions of the head. These are considered secondary headaches because the pain is not truly in the head.

Tension-type headaches most often present as a dull, diffuse aching sensation. The pain is usually poorly localized and may feel like tightness in different areas of the head. You are unlikely to experience significant relief from a tension-type headache if you take NSAIDs (e.g., ibuprofen [Advil], naproxen [Aleve], or other over the counter anti-inflammatory medications).

Common tension-type headache patterns include:

  • Suboccipital muscles: pain in the back of the head at the base of the skull or around the eyes (described as orbital headaches); this pain will only present on the same side as the trigger point(s)
  • Upper trapezius: pain tracing up the side of the head and around the ear; this pain will only present on the same side as the trigger point(s)
  • Sternocleidomastoid: pain in front of or behind the ear or along the forehead; the ear pain will only present on the same side as the trigger point(s), but the forehead pain may present on either side