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Tension Headache Diary

Print this tension headache diary and use it to keep track of your tension headaches.

Date

 

 

 

 

Time Headache Began

 

 

 

 

Time headache Ended

 

 

 

 

Warning Signs (aura)

 

 

 

 

Location of Pain

 

 

 

 

Type of Pain (pressing, throbbing, piercing, etc.)

 

 

 

 

Intensity of Pain* (circle one number to the right)

1 2 3 4 5 6 7 8 9 10

1 2 3 4 5 6 7 8 9 10

1 2 3 4 5 6 7 8 9 10

1 2 3 4 5 6 7 8 9 10

Other Symptoms (nausea, vomiting)

 

 

 

 

Medication Taken/ Other Treatment

 

 

 

 

Effect of Treatment

 

 

 

 

How Headache Affected My Normal Routine

 

 

 

 

Hours of Sleep the Night Before the Headache

 

 

 

 

What I Ate Before the Headache (caffeine, diet soda, chocolate, hot dogs, food with artificial sweeteners, processed foods)

 

 

 

 

Activities Before Headache Occurred

 

 

 

 

Important or Stressful Events That Occurred Today

 

 

 

 

Comments

 

 

 

 

 

 

WebMD Medical Reference

Reviewed by Neil Lava, MD on June 01, 2012
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