A tension headache feels like a band tightening around your head, or a dull pressure at the temples and the back of the skull. For many people it starts lower down, in the muscles of the neck and shoulders, which is why warming those muscles often helps more than treating the head itself.
Why your neck causes headaches
The muscles running from the top of your shoulders to the base of your skull attach right where many headaches are felt. When they’re tight from hours at a screen, poor sleep or stress, they pull on those attachments and can refer pain up over the head and behind the eyes. The screen side of this is tech neck.
A clue this is your pattern: pressing firmly at the base of your skull or on the top of your shoulders reproduces or increases the headache. Those tender spots are covered in muscle knots, heat and a massage ball.
How to use heat
- Sit upright in a supportive chair, somewhere quiet.
- Drape the pad over the back of your neck and the tops of your shoulders, cover on, lowest setting. A wrap sits better here than a flat pad: heated wraps vs a flat pad.
- 15–20 minutes. Close your eyes and let your shoulders drop.
- Afterwards, do slow chin tucks and side tilts, 10 of each. See heating pad for neck pain.
Keep the pad on the neck and shoulders, not over your face or eyes.
Heat or cold?
Useful rule of thumb:
- heat on the neck for tension headaches,
- cold on the forehead for migraines
People with migraine often want a cool, dark room and find warmth unpleasant. If you’re unsure which you have, try one for 15 minutes and see.
Your own preference is a reasonable guide here. The general version of the question is in heat or ice: a physio’s decision guide.
The rest of the picture
- Water. Dehydration is a common headache trigger, and easy to hit in Singapore’s heat.
- Screen height and breaks. Every 30–45 minutes, look away and move. See upper back pain from desk work.
- Sleep and jaw clenching. Poor sleep and grinding your teeth at night both feed tension headaches. See jaw pain and a warm compress and warmth before bed.
- Painkiller overuse. Taking painkillers for headaches on most days can cause medication-overuse headache, where the treatment keeps the headache going. If you’re reaching for them more than a couple of days a week, see a doctor.
- A neck that’s stiff as well as sore. If mornings are the worst of it, see a stiff neck after waking up; if it’s a daily background ache, neck arthritis.
Go to A&E or call 995 if…
- The headache came on suddenly and severely, peaking within a minute or two, the worst you’ve had
- It comes with fever, a stiff neck, a rash, or dislike of bright light
- There’s confusion, slurred speech, weakness or numbness on one side, or drooping of the face
- It followed a head injury
- You have sudden vision loss, or a very painful red eye
See a doctor if…
- Your headaches have changed in pattern, or are getting more frequent
- They wake you from sleep, or are worst first thing in the morning
- They’re worse when you cough, strain or bend forward
- You’re over 50 and getting new headaches, particularly with scalp tenderness or jaw pain when chewing
- You need painkillers for headaches most weeks
Heat is a comfort measure for the muscular kind. It isn’t a substitute for finding out why the headaches keep coming. Before you start, check who should not use a heating pad.
The heat pad we use
We’ve supplied the Bremed BD7800 since 2010. It holds a steady temperature, covers a whole lower back and has a machine-washable cotton cover. Physiotherapy clinics in Singapore use it with their patients.
Clinically reviewed by: Nigel Chua (Hand Occupational Therapist) & Louise Yow (Physiotherapist). This article is general information, not a diagnosis. electricheatpad.com sells electric heat pads.
