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Headache, Tension

Assim AlAbdulKader, MD, MPH and Jason Chao, MD, MS Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Typically characterized by bilateral mild to moderate pain or pressure without other associated symptoms

  • Three types of tension-type headache (TTH):

    • Infrequent episodic TTH: <1 day ...

DIAGNOSIS

HISTORY

Obtain a thorough pain history to rule out other headache disorders, including onset, location, radiation, quality of pain, severity, associated symptoms; concurrent medical condition...

TREATMENT

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and aspirin are effective for short-term relief of episodic TTH (2),(3)[B].

  • Amitriptyline should be considered first line for pro...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Keep headache diary to identify triggers, monitor progress, and prevent medication-overuse headache.

  • Regulate sleep schedule.

  • Regular exercise

DIET

  • Identify and avoid...

REFERENCES

1
Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia.  2018;38(1):1–211. [Vie...

SEE ALSO

Algorithm: Headache, Chronic 

CODES

ICD10

  • G44.209 Tension-type headache, unspecified, not intractable

  • G44.219 Episodic tension-type headache, not intractable

  • G44.229 Chronic tension-type headache, not intractable

  • G44.201 Tension-type ...

CLINICAL PEARLS

  • Don’t perform neuroimaging studies in patients with stable headache.

  • Don’t recommend frequent or prolonged use of over-the-counter (OTC) pain medications for headache.

  • Medication-overuse...

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