Tension headache S/S?

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Tension-type headaches are defined by a bilateral, pressing or tightening sensation that often involves muscles of the head and neck. The pain frequently localizes to the neck and occipital region because of associated neck muscle tension and pericranial tenderness. Seeing this pattern—pain that is more intense at the base of the skull or along the neck—fits the common distribution patients describe with tension headaches and helps distinguish it from other headache types that are more focal or pulsatile in other areas. While it’s true that tension headaches usually lack focal neurological deficits and can feel “vise-like” or tight, the localization to the neck or back of the head is a practical descriptor that reflects the typical muscle-tension pattern underlying this type of headache.