Any activity that causes the head to be held in one position for a long time without moving can cause a headache. Such activities include typing or other computer work, fine work with the hands, and using a microscope. Sleeping in a cold room or sleeping with the neck in an abnormal position may also trigger a tension headache.
Medication and Substance Overuse. About a third of persistent headaches — whether chronic migraine or tension-type — are medication-overuse headaches. These are the result of a rebound effect caused by the regular overuse of headache medications. Nearly any headache medication can produce this effect. Headaches can also occur after withdrawing from caffeine, nicotine, or alcohol.
Poor Posture and Work Conditions . Working or sleeping in an awkward position can contribute to posture problems (especially those that affect muscles in neck and shoulders) that trigger headaches. Eyestrain caused by overwork can also play a role.
Fatigue . Lack of sleep and tiredness from overwork are also headache triggers.
Foods and Beverages . Rapid consumption of ice cream or other very cold foods or beverages is the most common trigger of sudden headache pain, which may be prevented by warming the food or drink for a few seconds in the front of the mouth before swallowing. Not eating on time is also a trigger for headache.
Physical Activity . Intense physical exertion (including athletics or sexual activity) as well as lack of physical activity can trigger headaches. However, tension-type headache pain is not worsened by routine physical activity.
Dental Problems . Jaw clenching or teeth grinding, especially during sleep, are signs of temporomandibular joint dysfunction (TMJ, also known as TMD). TMJ pain can occur in the ear, cheek, temples, neck, or shoulders. This condition often coexists with chronic tension headache. Some patients with TMJ may see improvement in tension-type headaches from procedures or exercises therapies that specifically address the dental condition.
Physical Trauma . Whiplash or head or neck injury can lead to headaches.
Hormonal Changes . Hormonal changes, such as those that occur during the menstrual cycle or perimenopause, can affect headache occurrence.
Other triggers of tension headaches include:
- Alcohol use
- Caffeine (too much or withdrawal)
- Colds, the flu, or a sinus infection
- Dental problems such as jaw clenching or teeth grinding
- Eye strain
- Excessive smoking
- Fatigue or overexertion