It’s 4 p.m., you’ve been at your desk all day, and your head hurts. You’re not alone, just one of millions who suffer from tension headaches. “This is the name given to the ‘common’ headache,” says Cheryl Shea, D.C., a chiropractic physician at Complete Wellness Center in Kirkwood.

“By definition, tension headaches can be related to the vascular system (blood vessels), muscular tension or myofascial (connective tissue) tension,” Shea continues. “Tightened muscles of the face, neck, shoulders or scalp can result from posture or stress. And those tightened muscles can pinch off the nerve and blood supply to the muscle, as well as pinch off the drainage of waste.”

Shea contrasts tension headaches to migraines, which are typically marked by rapid-onset, throbbing pain that may be confined to one side of the head. Classic tension headache symptoms include mild to moderate pain around the temples that may occur during times of stress or after being in one position, such as seated at a desk, for a long period of time.

Most primary-care physicians recommend using over-the-counter pain medications, such as ibuprofen or acetaminophen, for relief. However, Shea notes that frequent use of these pain remedies can increase the number of headaches, so she advises patients to use these medications no more than three days per week. “Analgesics should be a short-term measure until the underlying cause of the headache is uncovered,” she says.

To combat tension headache onset, Brenda Kingen, D.C., of Kingen Chiropractic Wellness Center in Brentwood, says that workstation ergonomics should be closely examined. She urges patients to ensure that their keyboards and computer screens are at the proper height and distance to minimize muscle strain.

The other key to preventing tension headaches is to stretch regularly throughout the day, Kingen says. She often recommends using a fitness ball to keep muscles loose. “I have a lot of patients who sit on a ball at work,” she says. “This forces them to engage their core muscles a bit and allows them to stretch during the day.”

Kingen examines the posture of patients and often takes X-rays of the upper portion of the spine to ascertain whether the vertebrae and disks are healthy and properly aligned. In some cases, she works with primary-care physicians to rule out other potential causes.

Each chiropractic physician interviewed for this article spoke of the importance of proper nutrition and the use of certain supplements, such as magnesium, to help combat tension headaches and support good health in general. As a functional medicine practitioner, David Peterson, D.C., of Wellness Alternatives in Town & Country, makes diet, nutrition and lifestyle cornerstones of his practice approach.

“After taking a history, I ask the patient to identify the specific location of the headache,” Peterson says. After additional exam techniques, he determines which physical points are most in need of treatment and works to restore proper circulation and relieve tension. “I’ve had patients who have been on drugs for 15 years or more, and after two or three treatments, their headaches are gone,” he says.

Peterson uses a method known as chiropractic craniopathy to restore circulation in the head and finds it is an effective technique. “The 22 bones of the skull move throughout life, and if something happens to impair this movement, it can alter circulation of blood to the brain,” he explains. However, Peterson adds that to prevent tension headaches, “sometimes simple is best.”