19th June 2023

Diagnosis

Tension headache is the most common primary headache disorder.

Clinical features include:

• Generalised (or more rarely unilateral) headache, often described as a ‘band-like’ tightness around the head. It can seem to originate from, or spread to, the neck.
• Mild to moderate intensity headache lasting minutes to days. It does not tend to be exacerbated by routine physical activities.
• Common triggers or exacerbating factors include stress, caffeine intake, and disturbed sleep.
• On examination, pericranial tenderness to touch may be present.
• Tension headaches can be classified into different types depending on the frequency of episodes:
  • Infrequent (<1 episode/month)
  • Frequent (episodes 1-14 days/month for >3 months)
  • Chronic (15 days or more/month for >3 months)
• Tension headaches may be associated with photophobia or phonophobia. Nausea and vomiting are not common features.