How is tension-type headache diagnosed?


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How is tension-type headache is diagnosed is a common question we get as neck health experts.

Tension type headache is the most prevalent of all headaches.  A tension-type headache is a  feeling of a dull, aching pain that typically affects both sides of the head.

Ruling out other types of headaches

To diagnose tension-type headaches, it’s important to rule out other types of headaches, like migraines or cluster headaches. A healthcare provider may use specific criteria outlined in the International Classification of Headache Disorders (ICHD) to differentiate types of tension-type headaches.

The International Classification of Headache Disorders of 2018 distinguishes three subtypes of Tension-type Headache, according to the frequency of the episodes:

    1. Infrequent Episodic Tension-Headache type
    2. Frequent Episodic Tension-type Headache and
    3. Chronic Tension-type Headache

How is tension type headache diagnosed?

The diagnosis is primarily based on a thorough clinical evaluation by a healthcare provider. The recognition can rely on a combination of the following:

  1. Medical History:
    • The healthcare provider will take a detailed medical history, including information about the frequency, duration, and characteristics of your headaches. They will ask about any triggers or patterns related to your headaches.
    • Tension type headache is a feeling of tightness or pressure around the head.
    • Patients will have at least 10 episodes per year with a duration ranging from 30 min to 7 days.
    • The profile of a patient diagnosed with tension headache is typically
      1. female (80%)
      2. white (65%) and
      3. with an average age of 40 years.
  2. Description of Symptoms:
    • The nature of your headaches, including the location of the pain, the quality (dull, aching), and any associated symptoms like sensitivity to light or noise will be asked.
    • The parietal, frontal and suboccipital region is typical headache location.
    • Tension type headaches may have discomfort when exposed to light or noise, but not both at the same time.
    • All subtypes of tension-type headaches share a common characteristic.
      • Bilateral non-pulsatile pain of oppressive nature and mild to moderate intensity does not worsen with movement or is associated with nausea or vomiting.
      • However, mild nausea exclusively appears in the Chronic Tension-type Headache.
  3. Physical Examination:
    • A physical examination will assess myofascial trigger points.
    • Patients with tension type headache exhibit increased presence and tenderness of myofascial trigger points in pericranial muscles.

Concluding remarks on the diagnosis of tension type headache

The diagnosis of tension-type headaches is based on a pattern of recurrent, non-pulsating, mild to moderate headache pain.

It is important to consult a physician for an accurate diagnosis as physical therapists cannot diagnose headache types.

Treatment options for tension type headaches

We provide a comprehensive treatment approach through our Headache Relief Program.  This includes manual therapy and exercises to improve neck posture and mobility. The primary goal of treatment is to address the underlying cervical spine issues and alleviate myofascial trigger points causing tension type headaches.

Don’t hesitate to contact us today so we can help you!