What should you know about intractable tension headache?

Tension-type headache often feels like pressure or a tight band around the head, with tenderness in the scalp, neck or shoulders. It may be linked with muscle tension, stress, poor sleep, prolonged screen posture or jaw clenching. An intractable pattern means pain is persistent, repeatedly returns or does not respond to the measures that usually help. A headache is not automatically a tension headache because the location and quality of pain can overlap with migraine and other conditions.

Arrange a GP consultation if the pain is lasting longer than usual, becoming more frequent, affecting sleep or work, or requiring repeated pain medicine. Bring a record of timing, severity, sleep, meals, hydration, screen use, stress, jaw clenching and every medicine taken. Gentle neck movement, regular breaks, hydration, consistent sleep and a warm compress may help some people. Use over-the-counter medicine only according to its label and ask for advice if you need it often, because frequent use can maintain headaches.

Get emergency help for a sudden severe headache, new weakness, numbness, confusion, difficulty speaking, fainting, seizure, fever with a stiff neck, new vision loss or headache after injury. Seek prompt assessment for a new headache with persistent vomiting, a major change in your usual pattern or a headache during pregnancy or after childbirth. These features need consideration beyond tension-type headache.

Does the pattern fit tension-type headache? Could my medicines, sleep, vision, jaw or neck be contributing? What is a safe plan for acute pain? When should I consider preventive treatment or referral? Which warning signs should prompt urgent care?