How can STRESS cause HEADACHE? By Winnie Lim Khoo MD FPNA

Headaches are a common response to stress. The 3 most common types of headaches seen in an outpatient care setting are muscular tension headaches, migraines, and temporomandibular joint pain. These headaches have different causes, but the underlying initiator is often stress.

Stress can cause muscular tension headaches because the stress reaction (or fight-or-flight response) naturally causes your spine to tighten. Your spine muscles are connected to the muscles and connective tissue of your scalp, so your scalp muscles tighten, too, in stress and this can generate a headache. This kind of headache is often diffuse and described as “tight” or “squeezing.”

Migraine headaches work differently. They are caused by blood vessels in the brain that first constrict and then over dilate. Since this increase in pressure is within a fixed area of your skull, you feel pain. Migraines can be precipitated by stress, and they can also be precipitated by beverages and foods such as red wine and processed foods containing certain preservatives such as nitrates. They are also commonly precipitated by hormonal changes before a woman’s menstrual cycle or in the perimenopausal period, when hormones fluctuate rapidly.

Temporomandibular joint (TMJ) pain is caused by inflammation in the small joint of the jaw, called the temporomandibular joint. This small joint can become inflamed if a person clenches or grinds his or her teeth at night or if the mouth remains open for long periods of time, such as at the dentist’s. Stress can also cause tightening of the TMJ muscle, causing pain. The TMJ joint often refers the pain to the scalp area, causing a headache.