Although neurological examination is normal, the majority of patients with tension-type headache have tight muscles in their temples, neck and shoulders. Some have poor movement of the neck. The causes of tension-type headache are controversial. Importantly, the name tension-type headache does not imply that the headache is thought to be due to primarily a psychological problem. Tension-type headache is much more common than migraine headache.
All tests are normal in tension-type headache.
Like migraine, there is no reason to have a brain MRI or CT scan if the history and examination are consistent with uncomplicated tension-type headache. Drug Therapy Drug therapy is often recommended for tension-type headache. For these patients, non-drug therapy may be more important. Prophylactic headache medications are those drugs that are taken every day, regardless of whether a headache is being experienced, in the hopes of preventing headache attacks. The first dose is relatively low, and the dose is gradually increased if a headache occurs and if no intolerable side effects are experienced by the patient.