Tension Headaches: Description, Symptoms, and Treatment

Tension headaches are generally characterized by “pain or discomfort in the head, scalp, or neck, and is often associated with muscle tightness in these areas” (US National Library of Medicine). Tension headaches are the most common type of headache, with pain that is often described as having a band squeezing around the patient’s head. These types of headaches occur when the neck and scalp muscles become more tense, or contract. The muscle contractions can be in response to a number of things, including stress, depression, head injury, or anxiety. Because of this, tension headaches can be secondarily service connected to conditions such as PTSD, depression, anxiety, and other such service-related impairments.

As always, it is important to talk to your physician regarding your headaches so they can assist you in finding the correct diagnosis. There are many types of headache conditions, and given that a high proportion of them have similar symptoms but different treatment methods, it is important that your doctor identifies the correct condition for you to ensure that you are receiving the care that you need. While the symptoms associated with tension headaches vary from person to person, there are a number of distinctive symptoms that many people with tension headaches experience, including:

– Mild to moderate pain or pressure in the front, top, or sides of the head

– Headache that starts later in the day

– Trouble sleeping

– Feeling very tired

– Irritability

– Trouble focusing

– Mild sensitivity to light or noise

– Muscle aches

– Tightness of neck, scalp muscles

– Tightness of jaw or shoulder muscles

People who suffer from tension headaches may also realize that there are triggers that can induce tension headaches. These may include fatigue, anxiety, hunger, caffeine, alcohol, smoking, low iron levels, and/or other associated environmental and psychological factors.

Getting Service Connected for Tension Headaches: What Evidence is Needed

Because no specific rating schedule exists for tension headaches, the VA evaluates tension headaches based on the rating schedule for migraines (see next section), given that the two conditions are considered “closely analogous” under 38 CFR 4.20. You are eligible for service connection for tension headaches if (1) your condition was diagnosed in service or within twelve months of discharge or (2) your tension headaches are caused by another service-connected impairment. 

Many veterans experience incapacitating tension headaches multiple times per week, which, as any vocational expert will opine, precludes one’s ability to follow any substantially gainful occupation (SGO) in that no competitive employer will tolerate the unscheduled, unpredictable absences caused by tension headache attacks. Such veterans are entitled to a TDIU rating, which pays 100 percent compensation on a permanent and total basis. 

How the VA Rates Tension Headaches

Like all headache conditions, tension headaches are evaluated using the schedule for migraine headaches under Diagnostic Code 8100, with a maximum schedular rating of 50 percent. 

50 Percent:

With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability

30 Percent:

With characteristic prostrating attacks occurring on an average once a month over last several months

10 Percent:

With characteristic prostrating attacks averaging one in 2 months over last several months

0 Percent (Noncompensible):

With less frequent attacks

Helpful definitions

Though the VA’s regulation containing Diagnostic Code 8100, 38 CFR 4.214(a) does not define the terms “prostrating,” “severe economic inadaptability,” and “very frequent” or “less frequent,” the VA’s Manual M21-1MR defines these terms as follows: 

  • Prostrating – means “causing extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities.”
  • Completely Prostrating – means “extreme exhaustion or powerlessness with essentially total inability to engage in ordinary activities.”
  • Severe economic inadaptability – “denotes a degree of substantial work impairment.  It does not mean the individual is incapable of any substantially gainful employment.  Evidence of work impairment includes, but is not necessarily limited to, the use of sick leave or unpaid absence.” (Italics Added)
  • Less Frequent – means “duration of characteristic prostrating attacks, on average, are more than two months apart over the last several months.”
  • More Frequent – means “duration of characteristic prostrating attacks, on average, are less than one month apart over the last several months.”

Contact the Veterans Law Office About Your Tension Headaches Claim

If you are a veteran experiencing tension headaches that you believe are due to your service, and are seeking assistance with your initial claim for service connection or want to increase your current schedular disability rating, contact us at the number above or via our online form for a free case evaluation. Our veterans disability attorneys are experienced in representing veterans in tension headache claims and can help you get the compensation you deserve.