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VILLANOVA, Pa.—When making a diagnosis, tension headache is based on the characteristic symptomatology and absence of pathology on physical examination, which includes a detailed assessment of the neurological status. The provoking factors of chronic tension headache should be leveled.

It is necessary to distinguish tension headache from an undeveloped form (forme fruste) of migraine, in which the headaches resemble tension headaches and have only a few signs of migraine; they are of low intensity and, as a rule, are stopped by drugs specific for migraine.

In case of severe headaches, the established diagnosis of tension headache should be reconsidered, since severe headaches are rare with this diagnosis.

Pain is one of the most common symptoms in modern clinical practice and one of the most common reasons people seek medical attention. When a patient has pain, the physician should always consider the following characteristics: onset, development, migration, nature, intensity, localization and irradiation, duration, causes of pain intensification and relief (British Association for the Study of Headache, 2010).

Adequate pain relief is not only helping in the event of acute pain, but also preventing the start of a pathological cascade of chronic pain syndrome development. Speaking about pain, one should remember about the pain threshold, which is individual for each, and the same level of irritation can be perceived differently, depending on the subjective pain sensation, from minor to severe pain in different people (Haag G. et al ., 2011; Sarchielli P. et al., 2012).

4500_01 Tension headache (HDN) is one of the most common diseases among all population groups, and despite its seeming harmlessness, it is included in the TOP-10 causes of disability in the world. Most people experience episodes of HDN from time to time, with women experiencing it more often than men. HDN also has a great impact on people's daily life, including family and social spheres, work, among other things, is a predisposing and aggravating factor for the development of anxiety and depression (Steiner TJ, Martelletti P., 2007; Stovner Lj. Et al., 2007 ).