Tension headache

Question 1

What is a tension headache?

Answer 1

The attacks are generalised throughout the head with a predilection for involving the frontal and occipital regions. The pain is typically expressed as being a ‘tight band’ around the head. It does not worsen with routine physical activity.

Question 2

What are the risk factors of a tension headache?

Answer 2

> Mental tension
Stress
Missing meals
Fatigue

Question 3

What is the epidemiology of a tension headache?

Answer 3

Tension-type headaches are probably the most common type of headache. In adults, the mean global prevalence of tension-type headache is 42%.

Question 4

What are the signs and symptoms of a tension headache?

Answer 4

> generalised head pain
> frontal or occipital head pain
> non-pulsatile head pain
> constricting pain
> pericranial tenderness
> sternocleidomastoid muscle tenderness
> trapezius muscle tenderness
> temporalis muscle tenderness
> lateral pterygoid muscle tenderness
> masseter muscle tenderness

Question 5

What investigations would you do for a tension headache?

Answer 5

> Clinical diagnosis

> CT/MRI/ LP to rule out other causes

Question 6

What is the management plan for a tension headache?

Answer 6

> Analgesia- aspirin/ paracetamol

> Antidepressants e.g. amitriptyline

Question 7

What are the complications of a tension headache?

Answer 7

> Peptic ulcer

Question 8

What is the prognosis of a tension headache?

Answer 8

Tension-type headaches are probably the most common type of headache in the general population. They are most common between the ages of 20 to 39 years and then decline. Self-treatment with simple analgesic medicine is usually effective.