IM
Tension Headache
- Most common type of headache
- It is due to head and neck muscles becoming tense and tight
Clinical Features:
- a. Usually bilateral, in the forehead, neck or generalized
- b. Like a tight band around the head (not throbbing)
- c. No nausea/vomiting
- d. Scalp & forehead tenderness usually MOJOOD
- e. Patient may have sensitivity to light & sounds (like migraine)
- f. No neuro features or aura
Triggering Factors
Mostly same as migraine (lack of sleep, dehydration, loud noise, glaring lights, stress etc)
Acute Treatment:
- a. Take a nap
- b. Eat something/ take fluids
- c. Simple analgesics like Panadol, NSAIDs. Muscle relaxants may be added (Relaxon tabs)
- d. No triptans or other migraine specific drugs
- e. Apply cold or hot packs to the head
Chronic Treatment:
Given if very frequent headaches.
- Antidepressants (amitriptyline)
- Relaxation techniques
Rapid Fire Questions on Tension Headache
- What is the cause of tension headache? tense muscles
- What are the triggering factors? lack of sleep, dehydration, sound light stress
- What is the treatment? Analgesics, Relaxon, Relaxation techniques
- Triptans and ergotamine are very good for this, right or wrong? wrong
- What is the nature of the headache? tightnening band, dull ache
- Any aura or neuro features? no
- Any associated nausea /vomiting? no
FM
Tension-type Headache
- Most common type of primary headache
- More in women than men .
- Mild to moderate in intensity
- Bilateral
- Pressing and tightening (non-pulsating) headache
- Not aggravated by movement such as walking or climbing stairs.
Pain Locator
- Most common type of primary headache
- More in women than men.
- Mild to moderate in intensity
- Bilateral
- Pressing and tightening (non-pulsating) headache
- Not aggravated by movement such as walking or climbing stairs.
Treatment
- OCT pain relieves: Aspirin or ibuprofen.
- Combination therapy: Aspirin or acetaminophen with caffeine or a sedative drug.
- Preventive involves the use of daily prophylactic medications antidepressants (amitriptyline low dose), behavioral therapies and physical therapy.
