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Headaches
Tension-type headache is the most common headache pattern. It often feels like a tight band or dull pressure across the forehead, temples, or back of the head.
Pain is usually bilateral and pressing or tightening rather than pounding. Intensity is mild to moderate for many people.
Nausea is mild or absent. Light or sound sensitivity, if present, is usually not as dramatic as migraine.
Stress, sleep loss, long screen time, and neck or jaw muscle load often sit in the background. Episodes can be infrequent or nearly daily.
Tension-type headache is a primary headache. Muscle tension, stress physiology, and central pain sensitization all can play a role.
It is not the same as migraine, and it is not the same as cervicogenic headache, though neck muscle load can blur the lines.
Overusing acute pain medication can turn an episodic pattern into a more stubborn daily headache, so we watch that carefully.
We clarify frequency, quality, triggers, medication use, and whether migraine or neck-driven features are hiding in the story.
Exam looks at cervical and pericranial muscle tenderness, jaw load, and neurologic findings.
Imaging is uncommon for classic tension-type headache. We escalate when red flags or an atypical course appear.
Medication management covers smart acute use and, when headaches are frequent, simple preventive strategies. We avoid medication overuse patterns.
Physical therapy, posture and ergonomic changes, sleep routines, and stress load reduction are often the real backbone of care.
If exam shows a clear occipital nerve or facet-driven neck story, we shift toward an occipital nerve block or medial branch blocks as appropriate. Botox is reserved for chronic migraine criteria, not typical tension-type headache alone.
Migraine more often throbs, interrupts routine, and brings stronger nausea or sensory sensitivity, sometimes with aura. Tension-type pain is usually pressing and milder. Mixed features are common, and we sort them in clinic.
If neck movement clearly starts or worsens the headache and exam points to cervical joints or soft tissue as the driver, we evaluate for cervicogenic headache.
Yes for many people. Sleep, hydration, screen breaks, stress tools, and neck mobility work reduce how often tension-type headaches fire.
Dr. Adam Nessim, interventional spine physician, Westport Longevity, Pain & Performance.
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