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Many patients present with symptoms of or a diagnosis of tension headaches.  The NICE Guidelines (2018) describes these symptoms as;

“generalised pressure or tightness around the head that often spread into the neck, which has a mild to moderate intensity and not aggravated by moderate activity”.


It is important to consider other more serious causes of headaches before making a diagnosis. These include traumatic onset, vascular disorders, rheumatoid conditions such as fibromyalgia or polymyalgia or migraines.  Once these are ruled out, then a diagnosis of tension headaches can be considered.


While it is reassuring to have a ‘diagnosis’, it does not identify the pain causing structure associated with the headache. Many patients will have tried medication such as painkillers or anti-inflammatory drugs without relief.  Many patients may also have been told that their headache is associated with stress. However, this could well be playing a big part but does not help identify the structures which are causing the pain and discomfort.


Experience of treating patients with symptoms of tension headache has shown that a band of tension, knotted muscle or trigger points can be located around the neck and shoulder area. When these areas are pressed or held they cause “referred pain” to the head, face, jaw and eyes.

Treatment options for tension headache include the use of acupressure, dry needling, stretching or soft tissue massage techniques on pressure points.

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