Like migraines, tension headaches seem to be more common in women than in men. Unlike migraines, which often make their initial appearance during adolescence, tension headaches usually begin in middle age. As such, their onset often is equated with the development of adult stresses, anxieties and depression that can characterize mid-life.
The name "tension headache" therefore can be said to describe a response by the body to emotional strains and pressures, rather than to excessive muscular tightness and resultant constriction of the scalp arteries, as was once widely presumed. In many such cases, researchers have found that patients complaining of frequent headaches, which are generally not migraines, also exhibit varying degrees of depression, anxiety and worry.
Despite these findings, many physicians and researchers still believe strongly that stress-induced muscular tension in the head, neck and shoulders can bring on tension headaches. This is supported by evidence of muscular tenderness in areas of the neck, the base of the skull, scalp, forehead, face, jaw, shoulders or upper arms in many tension-type headache sufferers. Others show signs of pronounced clenching of the teeth, suggesting that problems related to the temporomandibular joint (TMJ) are causative factors, along with cervical disorders, such as arthritis or degenerative disease of the neck and/or spine, leading to chronic muscular contraction.