Headache, Tension-type

Key Features

• Headaches that are often vise-like or tight in quality but not pulsatile

• May be exacerbated by emotional stress, fatigue, noise, or glare

• Patients also frequently complain of pericranial tenderness, poor concentration, and other nonspecific symptoms

Clinical Findings

• Usually generalized

• May be most intense about the neck or back of the head

• Not associated with focal neurologic symptoms

Diagnosis

• Diagnosis is made after exclusion of other causes of headache (see individual diagnoses, eg, Sinusitis, Acute)

Treatment

• Abortive therapy with simple analgesics is usually effective

• Anti-migraine preparations are not recommended unless the patient has comorbid migraine headaches

• Behavioral therapies that may be effective include biofeedback and relaxation training

• Treatment of comorbid anxiety or depression