⚕️ FREE MSRA PODCAST – Tension Headache

🎧 A clear, high-yield breakdown of this common,pressure-like primary headache – perfect for exam prep and real-life clinicalscenarios.

🧠 Key Learning Points

📌 Definition

• The most commonprimary headache, characterised by a dull, bilateral, pressure-like sensationaround the head or neck.

• Typically notassociated with nausea, vomiting, or focal neurological symptoms.

📌 Causes & Risk Factors

•Stress and anxiety 😰

• Poorposture 🪑

•Fatigue and sleep disturbances 😴

•Bruxism (teeth grinding) 😬

•Female gender 🚺

• Family history

•Excessive screen time or neck strain 💻

🧠 Mnemonic: “SLEEP” – Stress, Lifestyle, Emotion,Ergonomics, Posture

📌 Pathophysiology

• Multifactorial –involves increased pericranial muscle tension.

•Central sensitisation may play a role 🧠

• Potentialserotonin imbalance

📌 Symptoms

•Bilateral dull ache or pressure 🔁

• Feels like a tightband around the head

• No photophobia,phonophobia or nausea (or only mild)

• May have scalp orneck tenderness

🧠 Mnemonic: “BAND” – Bilateral, Aching,Non-throbbing, Dull

📌 Differential Diagnosis

• Migraine

• Cluster headache

• Cervicogenicheadache

• Sinus headache

•Raised ICP or red-flag secondary causes ⚠️

📌 Diagnosis

• Clinical diagnosisbased on history

• No imaging orbloods unless red flags present

• Red flags:thunderclap onset, focal neurology, altered consciousness, trauma, fever, orimmunosuppression

📌 Management

• 🧘 Lifestyle: stress reduction, posture correction, hydration, regularsleep

• 💊 Medication: Paracetamol or NSAIDs for acute episodes

• 🧠 Chronic: low-dose amitriptyline may be considered

• 🧠 CBT, mindfulness, headache diary

• ❌Avoid codeine or routine opioid use – risk of medication-overuse headaches

📌 Complications

• Medication overuseheadaches (rebound)

•Chronic tension-type headache 😖

• Reduced quality oflife if unmanaged

📌 Prognosis

•Episodic types resolve easily with self-care 🟢

•Chronic types may impair functioning and require longer-term management 🟠

• Avoid analgesicoveruse to prevent rebound headaches

📎 More MSRA Resources for Tension Headache

📝 Revision Notes: https://www.passthemsra.com/topic/tension-headache-revision-notes/

🧠 Flashcards: https://www.passthemsra.com/topic/tension-headache-flashcards/

💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/tension-headache-accordion-qa-notes/

🚀 Rapid Quiz: https://www.passthemsra.com/topic/tension-headache-rapid-quiz/

🎓 Full Course: https://www.passthemsra.com/courses/neurology-for-the-msra/

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