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3.5.4

Tension Headache

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 3, Central Nervous System Conditions.

Clinical Description

  • Headache over the back of the head, but sometimes over the entire head, described as a tight band around the head, usually worse in the afternoon.

General Measures

  • Refer to medical rehabilitation Services for muscle relaxation techniques. The importance of this diagnosis is the exclusion of other, more sinister conditions.

Exclude analgesia overuse headache.

Pharmacological

  • Amitriptyline, oral, 10-75 mg at night.

Complications and Referral Criteria

  • When there is atypical pain, suggestive of alternate diagnosis.
  • When there is poor response to therapy.

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