What Causes Tension Headaches & How to Actually Get Relief

Tension headaches are one of the most common types of headaches we see here at Walsh Chiropractic and Physical Therapy of Hagerstown, and they can feel like a band of pressure wrapping around your head—starting from the base of your neck and moving forward into your forehead.

But what’s actually going on inside your body when that happens?

It’s Not "All in Your Head"—It’s In Your Neck

What I typically see clinically is this: tension headaches are often rooted in soft tissue dysfunction, especially in the neck and upper shoulders.

There are some major muscles that live back there—like the upper trapezius and levator scapulae—plus smaller, powerful ones called the suboccipitals. These attach right at the base of your skull (called the nuchal line).

Here’s the catch: the C1 and C2 spinal nerves branch up underneath those muscles. So when things get tight—due to posture, stress, anxiety, depression, or even just spending too long hunched over your laptop—those muscles squeeze the nerves, and the irritation travels.

That’s why you feel that headache creeping forward, starting in the back and crawling up toward your temples and forehead.

What Causes All That Tension?

Glad you asked.

Here’s what I see most often:

• Forward head posture (a.k.a. “tech neck” from looking down at screens)

• Poor desk ergonomics

• Emotional tension and stress

• Long hours with arms in front (typing, driving, even knitting)

When your shoulders roll forward and your head juts out, your neck muscles are working overtime just to hold you up. That creates fatigue, inflammation, and—eventually—a chain reaction of tension that leads to headaches.

And when the levator scapulae gets tight, it doesn’t just affect your head—it can also limit your neck mobility. If you’ve ever woken up stiff, understanding the levator scapulae stretch for neck pain relief explains why this muscle flares up and how to loosen it safely.

The suboccipital muscles, though small, are another major contributor. When they’re locked up, you can feel the effects all the way across your brow. Proper suboccipital muscle stretching techniques help reduce pressure on the upper cervical spine and relieve that deep, nagging tension.

View Full Video Transcript Here

Tension headaches—typically, clinically, what I see is tension headaches are a soft tissue issue. And you say, "Well, why is that soft tissues?" Good question. It’s because in the, uh, back of the neck, you have some big muscles—you’ve got upper traps, you’ve got levators. Then you have these little suboccipitals here, right at the nuchal line, and they all attach here.

What’s interesting about that area is C1 and C2 branches of those nerves go up underneath those tissues, and they come up this way. So with postural tension, anxiety, depression—there’s a number of causes—and what happens is that’s where they can go ahead and tighten up and irritate those nerves. And you can feel that headache moving forward, forward, forward into the front, into, uh, the frontal area.

So typically, what we do is—how you treat that—is adjustment, of course, getting the neck, especially the upper cervicals, to relax. Okay. And then we do some soft tissue work on the suboccipital muscles, the levators, and the upper traps.

And honestly, typically what I see is relief by the patients almost instantly—at least to some degree, right? At least the severity is lessened by that. So that is your standard tension headache.

And I’m telling you—it usually hits teenagers and adults, and, uh, it’s very prevalent, especially with what I find clinically is people that are on the computer, people that work with their hands in front of them in a position like this. Because all that tension is being forward—what we call forward head carriage—rolling forward the shoulders. You’re putting stretch tensions and all that in the muscles that are holding you up. And those muscles—they end up getting fatigued and tired, inflamed, and then that starts the whole chain reaction.

So, What Do We Do About It?

At our clinic in Hagerstown, MD, we take a multi-step approach:

👐 Chiropractic Adjustments — especially at the upper cervical spine (C1–C2) — to get your spine moving and your nervous system calmed down.

💪 Soft Tissue Therapy — targeted muscle relief using techniques like myofascial release, dry needling, and trigger point work to ease chronic tightness.

🏃‍♂️ Physical Therapy & Rehab — personalized exercises and movement drills that restore balance and prevent tension from building up again.

🪑 Posture Correction Strategies — we don’t just treat the symptoms. We help you build awareness of how your body’s alignment (especially during sleep and screen time) is affecting your discomfort. You can start improving this today by adjusting your sleep elevation and pillow setup.

And the results? In most cases, patients feel relief right away—or at the very least, a noticeable reduction in the intensity and frequency of headaches.

Tension Headaches Don’t Have to Be Your “Normal”

Teenagers, adults, office workers—if you’ve been chalking this up to “just stress” or popping painkillers to push through your day… don’t wait. This is your body trying to tell you something.

Let’s get to the root cause, not just mask the symptoms.

👉 Schedule a free consultation today and let’s talk through what’s going on with your headaches—and how we can help you feel better naturally.

Author: Dr. Patrick Walsh Chiropractor | Certified in Physiotherapy | 13+ years of experience in natural pain relief

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