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

  1. What is the cause of tension headache? tense muscles
  2. What are the triggering factors? lack of sleep, dehydration, sound light stress
  3. What is the treatment? Analgesics, Relaxon, Relaxation techniques
  4. Triptans and ergotamine are very good for this, right or wrong? wrong
  5. What is the nature of the headache? tightnening band, dull ache
  6. Any aura or neuro features? no
  7. Any associated nausea /vomiting? no