Tension-type headache.

Abstract

Tension-type headache typically causes pain that radiates in a band-like fashion bilaterally from the forehead to the occiput. Pain often radiates to the neck muscles and is described as tightness, pressure, or dull ache. Migraine-type features (unilateral, throbbing pain, nausea, photophobia) are not present All patients with frequent or severe headaches need careful evaluation to exclude any occult serious condition that may be causing the headache. Neuroimaging is not needed in patients who have no worrisome findings on examination. Treatment of tension-type headache typically involves the use of over-the-counter analgesics. Use of pain relievers more than twice weekly places patients at risk for progression to chronic daily headache. Sedating antihistamines or antiemetics can potentiate the pain-relieving effects of standard analgesics. Analgesics combined with butalbital or opiates are often useful for tension-type pain but have an increased risk of causing chronic daily headache. Amitriptyline is the most widely researched prophylactic agent for frequent headaches. No large trials with rigorous methodologies have been conducted for most non-medication therapies. Among the commonly employed modalities are biofeedback, relaxation training, self-hypnosis, and cognitive therapy.

• Authors: Paul J Millea, Jonathan J Brodie
• Journal: American family physician (Am Fam Physician) Vol. 66 Issue 5 Pg. 797-804 (Sep 01 2002) ISSN: 0002-838X [Print] United States
• PMID: 12322770 (Publication Type: Journal Article, Review)

Chemical References

• Analgesics, Non-Narcotic

Topics

• Analgesics, Non-Narcotic (therapeutic use)
• Chronic Disease
• Humans
• Medical History Taking
• Physical Examination
• Tension-Type Headache (diagnosis, physiopathology, therapy)