Ch. 168, Headache This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 14. Neurologic Disorders Chapter 168. Headache Tension Headache Tension Headache Headache that lasts 30 min to 7 days and is nonpulsating, mild to moderate in severity, bilateral, not aggravated by exertion, and not associated with nausea, vomiting, or sensitivity to light, sound, or smell. Tension headache can be thought of as a state of cranial hyperalgesia with reduced endogenous pain modulation and enhanced pain potentiation.
More disabled patients require a multidimensional approach as described above.
Recognition of comorbid illness is essential. Migraine is often associated with chronic tension headaches, so treatments overlap. All rights reserved.