Start with understanding
A tension-type headache often feels like pressure around the head rather than a pulse. It may involve both sides, with tenderness around the scalp or neck. Everyday activity is generally still possible. That familiar pattern is useful to describe, but it does not identify every headache accurately.
At Primal, the first conversation is about the pattern: when headaches happen, how often they interrupt your day, and what else comes with them. The goal is to understand the problem before building a plan. A headache diary can make that conversation more specific than trying to remember your worst afternoon.
Video coming soon
Explore the written guide and illustrated lessons below.
Connect understanding to daily life
Pressure is a description, not a diagnosis
Tell your provider where the pain starts, whether it spreads, and whether it feels tight, throbbing, sharp, or electrical. Mention nausea and light sensitivity rather than assuming they are unrelated. Tension-type headache and migraine can coexist; one label may not explain every episode.
Look at the whole week
Sleep difficulties, stress, and caffeine can be relevant. Record what happened without deciding that one bad night caused the headache. Note start time, duration, severity, medication use, and what you could still do. Bring examples from a normal workday as well as a difficult one.
Make the plan measurable
Ask which change you should try first and what improvement would look like. You might choose fewer interrupted workdays or less time spent withdrawing from family activities as a useful goal. Changing ten habits at once makes it harder to know what helped. Keep the next step small enough to repeat.
Medication belongs in the conversation
Frequent use of headache medication can contribute to medication-overuse headache. Review your actual medication days with a qualified clinician rather than repeatedly increasing use on your own. Include nonprescription products and combination medicines; a simple written list is more useful than saying you take something occasionally.
When the pattern changes
A sudden, extremely severe headache, new weakness, trouble speaking, confusion, or a headache with fever and a stiff neck needs emergency assessment. A new or steadily worsening pattern also deserves medical review. Do not assume a familiar tension-headache history makes a new episode harmless.
Educational information complements individual guidance. Your health history, goals, and examination determine appropriate care.
Build your understanding
Five ideas to build your understanding. Swipe, use the arrows, or focus the slides and use your keyboard.
Does a tight neck prove the headache comes from my neck?
No. Neck discomfort can accompany several headache types. A provider considers the headache history and examination together before choosing care.
What should I bring to an appointment?
Bring a short diary, your medication list, and one concrete example of an activity the headaches interrupt. Include any symptoms that are new for you.
What the evidence means for you
Headache patterns can overlap
The International Headache Society separates tension-type headache from migraine and recognizes that both can occur in one person.
Put it to use: Describe different episode patterns separately when discussing care.
Keep in mind: Classification criteria support a clinical diagnosis; they are not a self-test.
International Headache Society · diagnostic classification →Repeated medication use deserves review
NHS guidance identifies medication overuse as a possible contributor to recurring headache and recommends tracking headache details.
Put it to use: Record medication days alongside headache days and review the pattern with your clinician.
Keep in mind: Patient guidance does not determine which medicine is appropriate for you.
NHS · patient guidance →