Condition- Tension Headaches

Question 1

How can tension headaches be categorised?

Answer 1

• Episodic: <15 days of the month
• Chronic: >15 days of the month

Question 2

Which parts of the head can the pain be felt during a tension-headache? + what is a common presenting phrase?

Answer 2

• By the occipital and frontal regions
• “Feels like a tight band aorund the head”

Question 3

List some triggers for tension headaches

Answer 3

• Stress/ anxiety
• Squiting
• Poor posture
• Anxiety
• Fatigue
• Dehydration
• Missing meals
• Noise
• Bright light

NOTE: They are PRIMARY headaches

Question 4

Summarise the epidemiology of TH headaches

(age, gender, occurance in population)

Answer 4

• Most COMMON type of headache
• More common in WOMEN
• More common in YOUNG ADULTS

Question 5

Describe some of the presentng symptoms of Tension Headaches… (SOCRATES)

Answer 5

• S: Bilateral pain- bitemporal/occipital
• O: Gradual Onset
• C: Non-pulsatile, dull ache, ‘tight band)
• R: Scalp muscle tenderness, shoulder and neck
• A: photo/phonophobia + stress
• T: Variable duration. 3-4hrs
• E: Responsive to OTC meds
• S: mild-moderate

Question 6

How would you manage a patient with Tension Headaches?

Answer 6

1. Reassurance
2. Reduce triggers- stress, dehydration
3. Avoiding meds that cause tension type headaches (e.g. opiods)
4. Simple analgesia (paracetamol, Ibuprofen, aspirin)
5. TCAs considered if chronic headaches