Diagnosis and symptoms6 min read
Tension-type headache: symptoms and how it differs from migraine
The most common type of headache is tension-type, and in a significant proportion the source is the neck. As distinguishing it from migraine entirely changes the direction of treatment, correctly describing the symptoms is the first step.
The typical pain pattern
The pain is usually bilateral and described as a band-like pressure around the head. Its character is constant and dull rather than throbbing.
It often begins at the base of the skull and spreads to the temples and forehead. Intensity is mild to moderate; it does not confine a person to bed but reduces concentration and productivity.
A course that builds through the day and peaks in the evening is typical. Clear reduction at weekends indicates the picture is related to the working routine.
Findings that distinguish it from migraine
Migraine is usually one-sided and throbbing; tension-type pain is bilateral and pressure-like. This is the most practical first criterion.
Nausea, vomiting and sensitivity to light and sound are common in migraine. In tension-type headache these are absent or very mild.
Migraine worsens with physical activity and the person wants to rest in a dark room. Tension-type pain usually eases with walking and light movement; this difference in response is distinguishing.
The relationship with the neck
Trigger points in the muscles at the back of the neck and base of the skull refer pain into the head. As this referral pattern is reproducible, it can be confirmed on examination.
Restricted neck range and stiffness in the upper cervical segments frequently accompany this picture. When found, they increase the likelihood the pain originates in the neck.
Prolonged screen work, forward-head posture and unsupported arm use are the most common triggers. Without correcting these three, medication alone does not give a lasting result.
Key points
- Tension-type headache is bilateral and pressure-like.
- Pain usually starts at the base of the skull and spreads to the temples.
- Unlike migraine, nausea and light sensitivity are not prominent.
- Easing with movement is a practical finding that separates it from migraine.
- Trigger points in the neck muscles can refer pain into the head.
Frequently asked questions
Is using painkillers a problem?
Occasional use is appropriate. Taking painkillers more than two or three days a week can lead to medication-overuse headache, in which frequency rises rather than falls.
Can an eyesight problem cause headache?
Uncorrected refractive error can contribute to headache. In frequent, persistent headaches, having had an eye examination is a point to clarify before assessing a neck origin.
When should I see a doctor?
Sudden very severe pain, pain with fever or neck stiffness, a first headache after the age of fifty, and headache with neurological symptoms should be assessed without delay.
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This content is for information only and does not replace medical diagnosis or treatment. Response to treatment varies between individuals. Please consult a healthcare professional about your symptoms.