TensionTypeHeadaches分析.docVIP

Tension Type Headaches Case Presenation Mary is 44 years old and is complaining of terrible headaches. Ok Mary tell me more about your headaches. Well I get terrible headaches. Nearly every day I seem to get a headache and nothing I do helps them. I am so used to them that I can continue working but it just makes life miserable. I have always been prone to headaches but the last few years they have gotten worse. Can you describe the pain to me? Well it starts at the back of my neck and then moves to both sides at the front of my head. It feels like someone is tightening a band around my head. Also the light sometimes hurts my eyes. Has the type of headache you get changed at all over the last couple of years and how often does it occur? No it’s the same headache I just get it more often. I used to get one or two a month but now I get about 6 a week. Do you get any nausea or vomiting with the headache? No. Tell me about your job and who is at home with you, particularly if you have any major stresses in your life. I work in a small grocery store part time, I’m divorced and my two sons are grown up now so I live alone. I have been on disability since I hurt my back 5 years ago but these headaches I get are far worse than my back pain. Do you feel depressed or anxious at all? Well sometimes I do feel anxious especially about money, which is a constant worry for me. But I don’t think I’m depressed. What do you take for your headaches? I usually take Motrin but now find that it does not help at all in fact I am getting more and more headaches. Sometimes I take eight a day trying to get rid of the pain.  Diagnosis Mary has tension type headaches that are bilateral mild to moderate headaches that she describes as a tight feeling around her head. She is able to continue her usual daily activities with the headaches and has no associated symptoms of nausea, vomiting, or phonophobia although she does have some photophonia. (Table 1). She has chronic tension headaches as t