Tension Headache

Question 1

Epidemiology of tension headache

Answer 1

75% females

Question 2

Criteria of tension headache (by International Headache Society)

Answer 2

1. The patient should have had at least 10 of these headaches2. The headaches last from 30 minutes to 7 days3. The headaches must have at least two of the following four:a. non pulsating qualityb. mild or moderate intensityc. bilateral locationd. no aggravation with routine physical activity4. Headaches must have both no N/V, and absent photophobia/phonophobia5.

Question 3

Management of tension headache

Answer 3

• Pt education “scalp muscles get tight like calf muscles when going up stairs”- Relax mind and body- Massage affected area- Stress reduction, relaxation therapy, yoga, meditation classes- Rx: mild only, avoid using tranquillisers and analgesics

Question 4

Clinical features of tension headache: Site

Answer 4

Frontal, over forehead and temples

Question 5

Clinical features of tension headache: Radiation

Answer 5

Occiput

Question 6

Clinical features of tension headache: Quality

Answer 6

Dull ache, like a tight pressure feeling, heavy weight on top of head, tight band around head, may be tightness or vice-like feeling rather than pain

Question 7

Clinical features of tension headache: frequency

Answer 7

Almost daily

Question 8

Clinical features of tension headache: duration

Answer 8

hours (can last days)

Question 9

Clinical features of tension headache: onset

Answer 9

after rising, gets worse during day

Question 10

Clinical features of tension headache: aggravating factors

Answer 10

stress, overwork with skipping meals

Question 11

Clinical features of tension headache: relieving factors

Answer 11

alcohol

Question 12

Clinical features of tension headache: associated features

Answer 12

lightheadedness, fatigue, neck ache or stiffness (occiput to shoulders), perfectionist personality, anxiety/depression