eMedicine Specialties > Emergency Medicine > Neurology
Headache, Tension: Follow-up
Updated: Sep 29, 2009
Follow-up
Further Outpatient Care
- Physical therapy for patients with headache includes warm and cold packs, ultrasound, and electrical stimulation.
- Regular exercise, stretching, balanced meals, and adequate sleep are part of a headache prevention program.
- Trigger point injections, occipital nerve blocks, or changes that improve posture may be used.
Deterrence/Prevention
Deterrence and prevention of headache may include the following:
- Physical therapy
- Biofeedback and relaxation therapy
- Cervical traction
- Injection of trigger points
Complications
Complications of headache may include the following:
- Undue reliance on nonprescription caffeine-containing analgesics
- Dependence on/addiction to narcotic analgesics
- GI bleed from use of NSAIDs
- Risk of epilepsy 4 times greater than that of the general population
Prognosis
- Headache may become chronic if life stressors are not changed.
- Most cases are intermittent and do not interfere with work or normal life span.
Patient Education
- For excellent patient education resources, see eMedicine's Headache Center. Also, visit eMedicine's patient education articles, Causes and Treatments of Migraine and Related Headaches and Tension Headache.
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Follow-up: Headache, Tension |
| References |
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References
Fumal A, Schoenen J. Tension-type headache: current research and clinical management. Lancet Neurol. Jan 2008;7(1):70-83. [Medline].
Silver N. Headache (chronic tension-type). Am Fam Physician. Jul 1 2007;76(1):114-6. [Medline]. [Full Text].
[Guideline] Martin V, Elkind A. Diagnosis and classification of primary headache disorders. In: Standards of care for headache diagnosis and treatment. Chicago (IL): National Headache Foundation; 2004. [Full Text].
[Guideline] Ruoff G, Urban G. Treatment of primary headache: episodic tension-type headache. In: Standards of care for headache diagnosis and treatment. Chicago (IL): National Headache Foundation; 2004. [Full Text].
Arena JG, Bruno GM, Hannah SL, et al. A comparison of frontal electromyographic biofeedback training, trapezius electromyographic biofeedback training, and progressive muscle relaxation therapy in the treatment of tension headache. Headache. Jul-Aug 1995;35(7):411-9. [Medline].
Bogaards MC, ter Kuile MM. Treatment of recurrent tension headache: a meta-analytic review. ALYSIS. Sep 1994;10(3):174-90. [Medline].
Carlsson J, Augustinsson LE, Blomstrand C, et al. Health status in patients with tension headache treated with acupuncture or physiotherapy. Headache. Sep 1990;30(9):593-9. [Medline].
De Benedittis G, Lorenzetti A, Sina C, Bernasconi V. Magnetic resonance imaging in migraine and tension-type headache. Headache. May 1995;35(5):264-8. [Medline].
[Best Evidence] Detsky ME, McDonald DR, Baerlocher MO, et al. Does this patient with headache have a migraine or need neuroimaging?. JAMA. Sep 13 2006;296(10):1274-83. [Medline].
Ficek SK, Wittrock DA. Subjective stress and coping in recurrent tension-type headache. Headache. Sep 1995;35(8):455-60. [Medline].
Goldstein JN, Camargo CA Jr, Pelletier AJ, Edlow JA. Headache in United States emergency departments: demographics, work-up and frequency of pathological diagnoses. Cephalalgia. Jun 2006;26(6):684-90. [Medline].
Iversen HK, Langemark M, Andersson PG, et al. Clinical characteristics of migraine and episodic tension-type headache in relation to old and new diagnostic criteria. Headache. Jul 1990;30(8):514-9. [Medline].
Landy S. Migraine throughout the life cycle: treatment through the ages. Neurology. Mar 9 2004;62(5 Suppl 2):S2-8. [Medline].
Silberstein SD. Tension-type headaches. Headache. Sep 1994;34(8):S2-7. [Medline].
Silberstein SD, Olesen J, Bousser MG, et al. The International Classification of Headache Disorders, 2nd Edition (ICHD-II)--revision of criteria for 8.2 Medication-overuse headache. Cephalalgia. Jun 2005;25(6):460-5. [Medline].
Tfelt-Hansen P. Acute pharmacotherapy of migraine, tension-type headache, and cluster headache. J Headache Pain. Apr 2007;8(2):127-34. [Medline].
Further Reading
Keywords
tension headache, tension-type headache, chronic tension headache, episodic tension headache, chronic recurring head pain, cluster headache, migraine headache, muscle contraction headache
Follow-up: Headache, Tension