What should be included in the physical exam for tension headaches?

Updated: Nov 21, 2017
  • Author: Michelle Blanda, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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The physical examination serves mainly to exclude the possibility of other headache causes.

  • Vital signs should be normal.

  • Normal neurologic examination

  • Tenderness may be elicited in the scalp or neck, but no other positive physical exam findings should be noted.

  • Pain should not be elicited over temporal arteries or positive trigger zones.

  • Some patients with occipital tension headaches may be very tender when upper cervical muscles are palpated.

  • Pain associated with neck flexion and stretching of paracervical muscles must be distinguished from nuchal rigidity associated with meningeal irritation.

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