When should I consider referring a patient with tension-type headaches for further investigation or specialist assessment?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Consider referring a patient with tension-type headache for further investigation or specialist assessment if there is uncertainty about the diagnosis or atypical symptoms, or if symptoms persist despite optimal management in primary care .

Seek specialist advice or consider arranging referral to neurology if symptoms are atypical or if there is diagnostic uncertainty, or if symptoms persist despite treatment .

Do not refer people with tension-type headache solely for reassurance purposes .

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