Tension headaches 

Diagnosis  

In the case of chronic or recurring headaches, medical professionals may perform physical and neurological assessments to subsequently identify the specific type and underlying origins of the headaches through the following methods: 

• History Taking 
  • Characteristics: Clarify whether the pain is characterized by pulsating sensations or if it remains constant, manifesting as dull, sharp, or stabbing. 
  • Intensity: Communicate the extent of pain’s severity by assessing its impact on daily functioning. This includes gauging the ability to work through headaches and any disruptions to sleep patterns. 
  • Location: Describe precisely where the pain is localized, whether it encompasses the entire head, is confined to one side, or concentrates on specific regions such as the forehead or behind the eyes. 

• Imaging Tests: For individuals with atypical or complicated headache patterns, diagnostic tests are recommended to eliminate serious causes like tumors. The two primary imaging techniques employed are: 
  • Magnetic Resonance Imaging (MRI): Combining magnetic fields, radio waves, and advanced computing, MRI scans produce detailed images of the brain. 
  • Computerized Tomography (CT): Involving a series of computer–guided X–rays, CT scans offer comprehensive views of the brain’s structure. 

Treatment  

Some patients experiencing tension–type headaches may choose not to consult a doctor and, instead, attempt self–treatment. Unfortunately, repeatedly using over–the–counter pain relievers can lead to a different kind of headache called medication overuse headache. 

Acute medications

Various medications, both over the counter and prescription, can help alleviate headache pain: 

• Pain relievers: Common nonprescription options like aspirin, ibuprofen, and naproxen sodium are usually the first choice. 
• Combination medications: These combine aspirin or acetaminophen with caffeine or a sedative, often providing better relief than single–ingredient options. Many of these are available without a prescription. 
• Triptans and narcotics: Triptans work well for migraines and tension–type headaches, while opioids are seldom used due to side effects and addiction risks. 

Preventive medications

Your doctor might prescribe medications to reduce the frequency and intensity of attacks, particularly if you experience frequent or chronic headaches unresponsive to pain relief and other treatments. Preventive options include: 

• Tricyclic antidepressants: These, like amitriptyline and protriptyline, are commonly used for tension–type headache prevention. Side effects may encompass constipation, drowsiness, and dry mouth. 
• Other antidepressants: Evidence also supports the use of antidepressants like venlafaxine and mirtazapine. 
• Anticonvulsants and muscle relaxants: Medications such as gabapentin and topiramate may also help prevent tension–type headaches, although further research is necessary.

Be patient with preventive medications, as they may take a few weeks to become effective after building up in your system. Your doctor will track their progress, and it’s important to avoid excessive use of pain relievers during this time to ensure the effectiveness of the preventive treatment. Consult your doctor regarding pain reliever usage while on preventive medication.