Tension-Type Headache

Tension-Type Headache

Although this is the most common type of primary headache disorder, many patients do not seek medical attention. Patients frequently complain of pericranial tenderness, poor concentration, and other vague nonspecific symptoms, in addition to constant daily headaches that are often vise-like or tight in quality but are not pulsatile. Headaches may be exacerbated by emotional stress, fatigue, noise, or glare. The headaches are usually generalized, may be most intense about the neck or back of the head, and are not associated with focal neurologic symptoms.

When treatment with simple analgesics is not effective, a trial of antimigrainous agents (see Migraine, below) is worthwhile. Techniques to induce relaxation are also useful and include massage, hot baths, and biofeedback. Acupuncture has helped some patients. Exploration of underlying causes of chronic anxiety is often rewarding. Local injection of botulinum toxin type A is sometimes helpful, has few systemic adverse effects, and requires only infrequent administration.

Posted in: Headache