Presentation: 22 y/o female tertiary student presented with a 6 month history of routine headache symptoms. She explained that in the morning she would be fine but each afternoon she would develop a severe tension headache that would remain for several hours or until she went to sleep. The headache was most concentrated around the suboccipital muscles bilaterally and around the left upper cervical spine segments. She mentions she has had neck pain and stiffness in the past but just figured it was related to her lecture/study posture. She is feeling unusually tired and lethargic (more so over the last two months) but denies any signs of illness and/or infection. There are no changes in her vision, hearing, sense of taste or smell. There have been no significant changes to her home or routine, including; bed, pillow, bags, shoes, perfume, glasses, or lighting. She denies any nausea or vomiting. She walks daily and participates in yoga 3x/week. Poor posture is something she has know she has for a long time – but has not actively tried to improve it. The headache does not wake her at night. She has not had any unexplained weight changes. She has consulted her general … Continue reading Chronic Tension Headache