Tension Headache.

 

Definition:

Tension headaches are the most common type of headache, and are of mild to moderate intensity.

 

 

Causes:

Tension headaches occur when the muscles around the head and the neck tighten, which causes

pain. They can be triggered by a number of different thing; stress, anxiety, tiredness, eye strain and

also bad posture.

 

Presentation:

A patient will describe the headache as bilateral (on both sides), and may say it feels like a tight

band is squeezing their head. They will feel a generalised ache, with no specific focus.

 

The headache can last from 30 minutes to 7 days.

 

 

Differential Diagnosis:

Ensure there has been no recent head trauma.

 

If a patient is suffering from other symptoms such as photophobia or nausea it may be another

type of headache.

 

If the patient is having recurrent headaches they should be referred to identify the cause (more than

1 a month).

 

 

Treatment:

Simple analgesics should be recommended, such as paracetamol. TWO tablets should be taken up

to FOUR times daily (every 4 to 6 hours), maximum EIGHT per day.

 

Physiotherapy on neck.

 

May require non drug methods, such as acupuncture or massage.

 

 

Self Help Advice:

Get eyes tested regularly.

 

Regular exercise and relaxation techniques can help prevent headaches.

 

Take regular breaks when using a computer.

 

Keep a diary to help determine triggers or patterns.

 

 

Sample Question:

A man in his 30s asks you to recommend a painkiller for him. On questioning he tells you that he takes lithium tablets. Which one of the following drugs ‘commonly included in non-prescription analgesic preparations’ would not be appropriate for this patient? 

 

 A dihydrocodeine 

 B caffeine 

 C codeine 

 D paracetamol 

 E ibuprofen 

 

 

Answers to all sample questions can be found by following the link under the Test Yourself tab.