Headaches that are mild to moderate in intensity, not accompanied by other symptoms and responsive to treatment within a few hours do not usually require medical attention. However, headaches that are severe, recurrent or chronic should be brought to a physician’s attention. Headaches that interfere with sleep, occur with activity or present with additional symptoms also require examination by a physician.     

During an evaluation for tension headaches, physicians take the patient’s medical history and perform a physical examination. Information provided during these steps can help physicians determine whether a patient’s symptoms are the result of a tension headache or an underlying medical condition (e.g., brain tumor, aneurysm).

While collecting a patient’s medical history, physicians may ask the patient about symptoms. Questions in a pain assessment may focus on the characteristics of the pain, including its severity, location, frequency and duration. It is also common for musculoskeletal tenderness to be discovered during the physical examination.

Correct diagnosis is important because researchers have found that some people who are diagnosed with tension headaches actually have another condition, such as TMJ disorder.

There is no particular test to diagnose tension headaches, so medical history and physical examination are the only way to diagnose this condition.  Other tests may be performed to rule out other serious causes of headaches.  Physicians may use a number of methods to determine the cause of the head pain. These include:   

• MRI (magnetic resonance imaging). MRIs use a powerful magnetic field to create images of structures and organs within the body, allowing a computer to produce clear cross-sectional or three-dimensional images. This test may be ordered to examine the brain and rule out aneurysm and a number of other serious causes.
  
  
• CAT scan (computed axial tomography).  This test allows for multiple x-rays to be taken from different angles around the patient. A computer analyzes the "slices" or cross-sectional images. Frequently after the first set of images is taken, the patient receives an intravenous (I.V.) injection of a contrast agent (dye) to better outline the body parts. Then a second set of images is taken. This test may be ordered to examine the brain and rule out aneurysm and a number of other serious causes.