Tension Headaches

Attacks of headache (usually bilateral) which are pressing or tightening in quality and of mild to moderate intensity lasting minutes to days

Aetiology

Associations

  • Stress
  • Depression
  • Alcohol
  • Skipping meals
  • Dehydration

Clinical presentation

Symptoms

  • Bilateral non-throbing headache
    • Episodic or chronic
    • Pressing tingling quality
    • Mild to moderate
  • Absence of N+V
  • Absence of photophobia or phonophobia
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Signs

  • They may be associated with tenderness of the scalp muscles, as their contraction is the primary source of the pain

Management

  • Simple analgesics are often effective but overuse should be avoided
  • Relaxation physiotherapy
  • Reassurance
  • Antidepressant - dothiepin or amitriptyline for 3 months