The Back & Neck Handbook

An independent, plain-English guide to back, neck and sports-injury care

Understanding pain

Tension-type headaches, posture and the neck

Two hands in grey knitted sleeves holding a white mug of tea beside a rain-speckled window

Many people notice that their headaches and their necks seem connected: a long day hunched over a laptop ends with a band of pressure around the head, or a stiff neck in the morning turns into a dull ache behind the eyes by lunchtime. This page explains how the most common kind of headache is described and which everyday triggers are linked with it.

Primary and secondary headaches

Doctors sort headaches into two broad groups. The National Institute of Neurological Disorders and Stroke describes primary headaches as headaches that are not caused by another condition; they include tension-type headache and migraine. Secondary headaches are a symptom of something else, such as an injury, an infection or another illness. The possibility of a secondary cause is exactly why certain headaches need prompt attention.

What a tension-type headache is

MedlinePlus, in its article on tension headache, calls it the most common type of headache and describes it as pain or discomfort in the head, scalp or neck, often associated with muscle tightness or tenderness in those areas. People describe it as pressure, a tight band, or a dull ache on both sides of the head rather than a throbbing pain on one side. NINDS notes that the pain is usually mild to moderate and feels like constant pressure, and that the word "tension" points to how emotional stress is an important trigger.

The exact reasons some people get tension-type headaches are not fully understood. NINDS mentions genes, brain signals and muscle tenderness as factors that research is exploring.

Everyday triggers, including the neck

Both MedlinePlus and NINDS list triggers that will sound familiar to anyone who works at a desk. MedlinePlus explains that any activity that keeps the head in one position for a long time without moving can bring on a headache, with typing and other computer work, fine work with the hands and using a microscope as examples. Sleeping in a cold room or with the neck in an awkward position is mentioned too. NINDS lists physical postures that strain the head or neck, such as reading, working on a computer or staring at a phone screen, alongside other common triggers.

Other triggers named in these sources include:

  • physical or emotional stress and mental strain;
  • not enough sleep, or poor-quality sleep;
  • eye strain;
  • jaw clenching or teeth grinding;
  • colds, flu or sinus infections;
  • alcohol, too much caffeine or caffeine withdrawal, and dehydration.

Because several of these tend to arrive together, a single cause can be hard to pin down. A long, stressful day at a screen, with a skipped lunch, little water and a late night, stacks up many of them at once.

Habits people look at

People who notice a pattern often look first at the things they can change. Common starting points are the height and distance of the screen, so the head is not tipped forward for hours; regular short breaks to stand, look into the distance and move the shoulders; a pillow and sleeping position that keep the neck in a comfortable line; regular meals and water through the day; and ways of winding down that suit them. The desk setup, posture and neck pain pages go into these in more detail.

Keeping a simple headache diary can also be useful: when each headache started, what you were doing, how you slept, what you ate and drank, and how long it lasted. That kind of record is helpful to bring to a health care provider, who can tell different kinds of headache apart and advise on care, including whether any medicine is suitable for you.

Get it checked promptly

Some back and neck pain needs prompt medical care rather than waiting it out: pain that follows a fall, a crash or a hard blow; pain that comes with numbness, tingling or weakness in an arm or a leg; any loss of bladder or bowel control; pain that comes with a fever; and pain that is severe or keeps getting worse. The fuller list, drawn from MedlinePlus and the American Academy of Orthopaedic Surgeons, is on When to see a doctor.

Headaches that need attention now

Not every headache needs a doctor, but some do, and quickly. MedlinePlus's headache overview advises letting a health care provider know about sudden, severe headaches, and getting medical help right away for a headache after a blow to the head, or a headache that comes with a stiff neck, fever, confusion, loss of consciousness, or pain in the eye or ear. A headache with a fever and a neck so stiff that the chin will not touch the chest can be a sign of a serious infection and is treated as an emergency. These signs, and others for the back and neck, are gathered on the When to see a doctor page.