Table 7.
When you have a headache, do you ever have discomfort (pain, tension, or tenderness) in the following areas? (Please tick (✓) one box for each item).
| Affected area | Never | Seldom | Sometimes | Often | Almost always |
|---|---|---|---|---|---|
| Neck | □ | □ | □ | □ | □ |
| Shoulders | □ | □ | □ | □ | □ |
| Ears | □ | □ | □ | □ | □ |
| Eyebrow | □ | □ | □ | □ | □ |
| Eyes | □ | □ | □ | □ | □ |
| Face | □ | □ | □ | □ | □ |
| Cheeks | □ | □ | □ | □ | □ |
| Jaw | □ | □ | □ | □ | □ |
| Nose/bridge of nose | □ | □ | □ | □ | □ |
| Others (please specify) | |||||