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

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 ¹.

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 ¹.

Do not refer people with tension-type headache solely for reassurance purposes ¹.