Tension Headache Signs and Symptoms

The typical tension headache is one that produces a dull, steady, achy pain on both sides of the head. This contrasts with the classic symptom of migraine, which is severe, throbbing or pulsating pain, usually on one side of the head.

However, a small proportion of tension-headache patients report that their pain, when at its worst, does at times develop a pulsating quality, a phenomena which physicians sometimes call a tension-vascular headache. This represents one more area where the distinction between tension headaches and migraines becomes somewhat blurred, and tends to support the theory that the two headache types are not actually separate conditions, but opposite ends of common spectrum of primary headache activity.

Many tension headache sufferers describe their pain as producing a sensation of pressure or tightness around the head, as though a band were pulled tightly around it; others compare the feeling to having their head clamped in an ever-tightening vise. The pain usually begins gradually and increases steadily over a period of hours, but while severe and distracting, it rarely becomes overwhelming and physically debilitating, as in a migraine.

Diagnosis of Tension Headache

Physicians typically diagnose tension-type headache on the basis of observed differences between its symptoms and those that characterize migraines, cluster headaches and other kinds of chronic craniofacial pain. With all patients who complain of abnormally frequent head pain, however, the physician usually will perform a thorough physical examination, including a medical history and one or more diagnostic procedures, to rule out any underlying serious medical problems that may be producing the headaches as a secondary symptom.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 01 Jan 2002

Last Modified: 18 Sep 2015