Tension Headache: Symptoms, Complaints, Signs

The International Headache Society gives the following symptoms for tension headache:

  • Pain usually bilateral (often fronto-occipital; toward forehead (frontal), occiput (occipital); sometimes headband-like).
  • Pain character: dull, pressing and pulling pain.
  • Pain intensity: mild to moderately intense pain.
  • Attack frequency: usually occurs over days or weeks. The pain leads to most sufferers that performance and well-being are limited.
  • Physical activity (eg, climbing stairs or similar physical activities) does not worsen the pain, but improves it.
  • Possible muscle tension in the neck and neck.
  • Depressive mood

Tension headache in old age

In episodic or chronic tension headache remember that it may be a secondary headache disorder.

Warning signs (red flags) [quick reference.]

  • Anamnestic information:
    • Tumor disease
    • Immunosuppression (suppression of the body’s own defense system).
    • Continuous medication: anticoagulation
  • Headache onset > 50 years of age
  • Clinical findings:
    • No clear diagnosis or atypical presentation.
    • Neurologic abnormalities: Seizures, brain-organic psychosyndrome (HOPS; collective term for mental and psychosocial disorders as a result of organic brain changes), focal neurological deficit without papilledema (congestive papilla; edematous swelling of the optic nerve papilla (papilla nervi optici) at the exit site of the optic nerve from the eyeball).
    • Abrupt explosive onset
    • Continuous headache
  • Other findings:
    • Fever
    • Increased blood cell sedimentation rate
  • For a comprehensive account of the trademarks, see below Cephalgia (headache).