Headache (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Jay W. Marks, MD
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
In this Article
- Headache facts
- What is a headache?
- How are headaches classified?
- What are primary headaches?
- What are secondary headaches?
- What are cranial neuralgias, facial pain, and other headaches?
- What causes tension headaches?
- What are the symptoms of tension headaches?
- How are tension headaches diagnosed?
- How are tension headaches treated?
- What causes cluster headaches?
- What are the symptoms of cluster headaches?
- How are cluster headaches diagnosed?
- How are cluster headaches treated?
- Can cluster headaches be prevented?
- What diseases cause secondary headaches?
- How are secondary headaches diagnosed?
- What are the exams and tests for secondary headaches?
- When should I seek medical care for a headache?
- Headache & Migraine Triggers - Slideshow
- A Visual Guide to Migraine Headaches - Slideshow
- Take the Headaches Quiz!
- Headaches FAQs
- Find a local Neurologist in your town
What are the symptoms of tension headaches?
Common presentation of tension headaches includes the following:
- Pain that begins in the back of the head and upper neck and is described as a band-like tightness or pressure. It may spread to encircle the head.
- The most intense pressure may be felt at the temples or over the eyebrows.
- The pain can vary in intensity but usually is not disabling, meaning that the sufferer may continue with daily activities. The pain usually is bilateral (affecting both sides of the head).
- The pain is not associated with an aura (see below), nausea, vomiting, or sensitivity to light and sound.
- The pain occurs sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people.
- The pain allows most people to function normally, despite the headache.
How are tension headaches diagnosed?
The key to making the diagnosis of any headache is the history given by the patient. The health care professional will ask questions about the headache to try to help make the diagnosis. Those questions may include learning about the quality, quantity, and duration of the pain, and asking about any associated symptoms. The person with a tension headache will usually complain of pain that is mild-to-moderate, located on both sides of the head, described as a tightness that is not throbbing, and not made worse with activity. There will be no associated symptoms like nausea, vomiting, or light sensitivity.
The physical examination, particularly the neurologic portion of the examination, is important in tension headaches because to make the diagnosis, it should be normal. However, there may be some tenderness of the scalp or neck muscles. If the health care professional finds an abnormality on neurologic exam, then the diagnosis of tension headache should be put on hold while the potential for other causes of headaches has been investigated.
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