Tension Headache
1. PRELIMINARY DATA
- No.: 227/2026
- Patient's Name: ABC
- Address: Flat 901, Horizon Apartments, Pune.
- Occupation: Accountant (long desk hours, computer work, mental stress)
- Religion: Hindu
- Date: 10/07/2026
- Age: 41 Years
- Sex: Female
- Education: M.Com
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Head (bilateral, occiput to forehead) | Tight band-like or pressing headache, dull aching, heaviness | < Mental exertion, < Stress/worry, < Prolonged reading/screen, < 3-5 PM, < Noise, > Rest in quiet, > Cold applications, > Pressure, since 9 years (frequent 3-4/week, worse last 3 years) | Neck/shoulder stiffness, eye strain, irritability, fatigue |
| Neck & Shoulders | Muscle tension, stiffness | < Sitting long | Anxiety about work, low mood |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Recurrent tension headaches since college; suppressed with painkillers; eye strain from studies; suppressed nasal allergy with sprays; occasional acidity.
- Family History: Mother has tension headaches. Father has hypertension. Sister has migraine.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal
- Desires: Warm drinks (+++), Salty snacks (+)
- Aversions: Cold food
- Thirst: Moderate
- Elimination:
- Urine: Normal
- Stool: Occasional hard
- Perspiration: Scanty
- Sleep: Disturbed by tension; wakes with headache
- Thermal State: Chilly patient (prefers warm room)
B. Reactions - Physical Factors
- Weather: Aggravation in cold weather
- Position: Better lying with head elevated
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Anxious, perfectionist, irritable
- Anxiety: About deadlines, family responsibilities
- Fear: Fear of losing job, fear serious illness
- Dreams: Being late, failing tasks, falling
- Other: Suppressed worry, feels overburdened
6. PHYSICAL GENERAL EXAMINATION
- Wt: 68 kg | Ht: 160 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 80 bpm | B.P.: 130/82 mmHg
- Face: Tense
- Tongue: Clean
- Nails: Normal
- Skin: Dry
7. SYSTEMIC EXAMINATION
- Nervous: Neck/shoulder muscle tenderness, no focal deficits
- CVS: S1, S2 Normal
- Respiratory: Clear
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Anxiety/perfectionism, irritability, fear illness (Grade 3)
- Physical General: Chilly, desire warm drinks, pressing headache (Grade 3)
- Particular: Chronic tension headache band-like, < exertion/stress/noise, > rest/pressure/cold (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic tension headache with strong Mental Generals (anxiety, irritability) and Physical Generals (thermal, modalities) dominating; Kent suits head rubrics for chronic headache.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Anxiety and perfectionism
- Irritability
- Fear serious illness
- Desire warm drinks
- Chilly patient
- Pressing band headache
- < Mental exertion, stress, noise
-
Rest, pressure, cold applications
- Neck/shoulder stiffness
- Eye strain
- Family headache history
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Anxiety | Mind; ANXIETY | 6 |
| 2 | Irritability | Mind; IRRITABILITY | 57 |
| 3 | Desire warm drinks | Stomach; DESIRES; warm drinks | 486 |
| 4 | Head pain pressing | Head; PAIN; pressing | 146 |
| 5 | < Mental exertion | Head; PAIN; mental exertion, from | 143 |
| 6 | > Pressure | Head; PAIN; pressure amel | 145 |
| 7 | Chilly | Generalities; COLD; agg. | 1348 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Nux Vomica | 7/7 | 21 |
| 2 | Bryonia Alba | 6/7 | 18 |
| 3 | Natrum Muriaticum | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Pressing pain, irritability, chilly | Chronic tension from stress | Family headache issues | Destructive fear illness |
Dominant Miasm: Psora
14. FINAL STEPS
- Provisional Diagnosis: Chronic Tension Headache
- Differentiation of Remedies: Compared Nux Vomica with Bryonia. Bryonia has > absolute rest, < motion; Nux Vomica matches stress-induced tension headache, irritable/fastidious, chilly, desire warm drinks, < exertion/noise, > pressure. Nat mur more grief/thirstless.
- Selection of Remedy (Materia Medica): Nux Vomica matches chronic tension headache from overwork/stress, pressing pain, irritability/anxiety, chilly patient, desire warm drinks (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic headache miasmatic case, sensitive constitution)
- Actual Prescription:
- Nux Vomica 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 8 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 20/08/2026 | Frequency reduced 60%, intensity milder, better concentration | Placebo | Regular breaks from screen, neck exercises, stress reduction |
| 20/12/2026 | Headaches rare, no daily occurrence, energy improved | Placebo | Maintain posture, eye rest, report triggers |