Muscle Contraction Tension Headache Clinical Presentation

Updated: Dec 28, 2015
  • Author: Manish K Singh, MD; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Presentation

History

Tension-type headaches (TTHs) are characterized by pain that is usually mild or moderate in severity and bilateral in distribution. Unilateral pain may be experienced by 10-20% of patients. Headache is a constant, tight, pressing, or bandlike sensation in the frontal, temporal, occipital, or parietal area (with frontal and temporal regions most common).

  • Ulrich et al reported that 82% of TTHs last less than 24 hours. [3]
  • The deep steady ache differs from the typical throbbing quality of migraine headache.
    • Prodrome and aura are absent.
    • Occasionally, the headache may be throbbing or unilateral, but most patients do not report photophobia, sonophobia, or nausea, which commonly are associated with migraine.
  • Some patients may have neck, jaw, or temporomandibular joint discomfort.
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Physical

See the list below:

  • Patients with TTH have normal findings on general and neurologic examinations.
  • Some patients may have tender spots or taut bands in the pericranial or cervical muscles (trigger points).
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Causes

Various precipitating factors may cause TTH in susceptible individuals. One half of patients with TTH identify stress or hunger as a precipitating factor.

  • Stress - Usually occurs in the afternoon after long stressful work hours
  • Sleep deprivation
  • Uncomfortable stressful position and/or bad posture
  • Irregular meal time (hunger)
  • Eyestrain
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