The evaluation of a tension headache begins with a history and physical exam.

Physical findings in someone with a tension headache may include:

• Neck tenderness:
• Along the neck muscles
• Along the spine
• Scalp tenderness:
• Over the back of the skull
• Across the forehead
• Muscle spasms in the neck

Tests are not necessary to make the diagnosis of a tension headache.

Tests that may be used to evaluate a tension headache include:

• Erythrocyte sedimentation rate
• Kidney profile
• Thyroid profile
• Visual acuity testing