Tension headaches Flashcards
what is a tension headache?
A common episodic primary headache
What is the difference between a primary and secondary headache?
Primary headache= common and chronic/ recurrent.
Secondary headache= acute and arise from specific underlying cause (tumour, trauma, infection)
What is the cause of tension headaches?
Increased sensitivity to pain due to release of vasoactive neuropeptides (e.g. substance P and calcitonin gene related peptides).
What are some of the triggers for tension headaches?
Triggers: extreme stress and dehydration. Can also co-exist with migraine
What are the risk factors for tension headaches?
- White individuals
- Biological females
- Age > 40
- Family history of tension headaches
- Individual with stress, anxiety, depression and/ or poor posture
What are the clinical features of a tension headache?
- Constant tight band-like pressure around the head
- Bilateral (often bifrontal pain)
- Non-pulsatile headache
- Scalp muscle often feels tender
- Moderate intensity
- Episodes last no more than a few hours
- The patient might also complain about stiff neck/ shoulders too
- There are no other associated symptoms/ aura
What other associated symptoms might you ask about? (just to check that they don’t have them)
- Photophobia
- Vomiting/ nausea
- Not aggravated by physical activity
How is diagnosis made?
Through thorough history
Generate a management plan for a patient with tension headaches?
ACUTE (first line)
- NSAIDS
- Paracetamol
- Aspirin
Prophylaxis- NICE recommend up to 10 sessions of acupuncture over 5-8 weeks
CHRONIC relief- low dose amitripyline and TCAs (anti-depressants)
Consider CBT and general advice like using heat and ice relief
