2.4.3 Probable chronic tension-type headache

A 44-year-old HGV driver reports headaches that have been affecting his sleep before early shifts. He describes the pain as an even, gripping tightness across the scalp rather than any pulsing quality, and confirms that neither loading the lorry nor a long stretch of motorway driving makes the pain worse. Typically an episode passes within around thirty-five minutes, well short of the hours-long or all-day pattern some people describe. He tells me this has been a steady, near-daily problem for close to four months. He is clear that he has never felt even a hint of nausea with these headaches, and has certainly never been properly sick or vomited because of one. Bright motorway signage and headlights do not seem to trouble him particularly, and cab noise on long runs has not made things any worse either. He counts roughly seventeen headache days in an average month.