Tension headaches

Tension headaches are dull or throbbing, usually bilateral headaches, of mild to moderate intensity and are not accompanied by significant accompanying symptoms (vomiting, visual disturbances, focal neurological symptoms).

According to the frequency of occurrence, tension pains are divided into episodic (less than 15 days in a month) and chronic (more than 15 days in a month).

Tension headaches can also occur in individuals with another primary or secondary headache. In some individuals, tension pains are associated with an increased tone of the pericranial artery and neck muscles.

Diagnostics[edit | edit source]

The main diagnostic criteria are in the table:

**Criteria for tension headache**
The patient must meet the criteria in at least two points:
A. Pressure or cramping pains
B. Pain of bilateral localization
C. Pains of mild or moderate intensity
D. The pains are not aggravated by physical activity, they are not accompanied by nausea or vomitus, may appear light photophobia or phonophobia

Therapy[edit | edit source]

The basis of successful therapy for tension headaches is thorough psychoeducation (identification of adverse factors, the adverse effect of mental imbalance, the ability to relax physically and mentally, life priorities).

For episodic tension headaches acetylsalicylic acid (Aspegic plv 500 mg), peripheral analgesics – paracetamol (Paralen 500 mg) are the drugs of choice. Another group are nonsteroidal antiphlogistics: ibuprofen (Ibalgin, Dolgit) in the dose 400–800 mg, indomethacin (Indomethacin supp) v in the dose 50–100 mg, naproxen (Naproxen tbl, supp) v in the dose 500 mg, diclofenac (Diclofenac tbl) in the dose 50–100 mg.

For chronic tension-type pain, the drug of first choice is amitriptyline in a dose 25–50 mg per night, drugs from the group SSRI (citalopram, fluoxetin,...) tend to be less effective.