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Difference Between Tension Headache and Meningitis

A tension headache is when the head hurts because of stress. Meningitis is an inflammation of the membranes of the brain.

What is Tension headache?


A tension headache is a pain in the head caused by stress and tension.

Causes and risk factors:

The cause of tension headache is usually stress. This is made worse by fatigue, lack of sleep, and eye strain. People who work long hours or have a stressful job are at higher risk of tension headaches.


Diagnosis is made based on symptoms and the lack of signs like nausea that would indicate migraine. The pain is also different compared to a migraine, which is a throbbing pain and is, instead, a tight feeling around the head. Imaging tests such as X-rays and MRI can be used to exclude other problems but only becomes necessary if the person does not improve or if the head pain worsens and other symptoms develop. 

Symptoms and complications:

The symptom is pain in the head. A tension headache feels like a tight band is being pulled around the head. The pain is not as severe as in a cluster headache or migraine and is more of a general pain felt all over the head or around the head like there is a tight band placed around the skull. This is different from and not as severe as the pain of a migraine or cluster headache.  The complication of tension headaches is a decreased quality of life. 


Treatment includes the use of mild pain killers like acetaminophen and anti-inflammatories. The person should be encouraged to change their lifestyle to reduce stress and to get more sleep.

What is Meningitis?


Meningitis is when there is an inflammatory response occurring in the meninges and the subarachnoid area of the brain.

Causes and risk factors:

The causes of meningitis include infections caused by bacteria or viruses, and very rarely, fungi. There are other causes of the condition including certain illnesses like cancer. Risk is highest among those with a bacterial or viral infection and who are either young children or older adults over 60.


Meningitis is suspected when a person has the symptoms including a stiff neck and lack of ability to bend the head over to touch the chest. It is also difficult for a person with the illness to extend the legs. Definitive diagnosis is made by a lumbar puncture and examining of the cerebrospinal fluid.

Symptoms and complications:

Symptoms of meningitis you would have include a very severe headache, fever, nausea and vomiting, and not being able to bend your neck forwards to place your chin on your chest.  Meningitis is a dangerous illness that can lead to kidney failure, seizures, hearing loss, memory loss, brain damage, and death.


Treatment depends on the cause and may include antibiotic therapy and corticosteroid medications. The person often needs to be hospitalized and carefully monitored.

Difference between Tension headache and Meningitis?


A tension headache is defined as a pain in the head caused by stress or tension. Meningitis is an inflammatory response of the membranes of the central nervous system.


The causes of tension headache includes stress, lack of sleep, and eye strain. The causes of meningitis are viruses, bacteria, fungi, and other illnesses.


The diagnosis of a tension headache is usually by physical exam and only sometimes imaging to exclude other conditions. The diagnosis of meningitis is by a physical exam and lumbar puncture.


The main symptom of a tension headache is a mild pain in the head, as though a band is being pulled around the head. Symptoms of meningitis include very bad head pain, fever, vomiting, stiff neck where the neck cannot be bent to touch the chest, and legs that cannot easily be stretched out.


A tension headache can be treated by medicines like acetaminophen and anti-inflammatories, along with change in lifestyle to reduce stress and get more sleep. Meningitis can be treated in the hospital with antibiotics and corticosteroids.

Table comparing Tension headache and Meningitis

Summary of Tension headache Vs. Meningitis

  • A tension headache is not as bad as a headache caused by meningitis.
  • Tension headaches are due to stress and tension.
  • Meningitis is caused by pathogens and illness.
  • Tension headaches often improve with pain killers and rest at home.
  • Meningitis often requires hospitalization and treatment because it is a dangerous condition.


How do I know if my headache is meningitis?

A headache is only one symptom of meningitis, if there are other signs like a stiff neck that you cannot bend, nausea, and fever, then it could be meningitis.

What kind of headache is associated with meningitis?

The head pain of meningitis is very bad; the usual pain killers will not help in the pain caused by this condition.

What can be mistaken for meningitis?

Certain illnesses like Rocky mountain spotted fever and ehrlichiosis have similar symptoms to meningitis. 

What part of neck hurts with meningitis?

The entire neck area will feel more stiff than sore but will feel much worse when you try to move your neck. Other causes of neck pain, like muscle strain, will improve with the usual pain killers, massage and muscle treatments, while meningitis neck pain does not get better with these sorts of treatments. 

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References :

[0]Francke, Elliot. "The many causes of meningitis." Postgraduate Medicine 82.2 (1987): 175-188.

[1]Greenlee, John E. “Meningitis” MerckManuals, 2020, https://www.msdmanuals.com/professional/neurologic-disorders/meningitis/overview-of-meningitis

[2]Silberstein, Stephen D. “Tension-Type Headache (Tension Headache)” MerckManuals, 2021, https://www.msdmanuals.com/professional/neurologic-disorders/headache/tension-type-headache

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