How do I distinguish a severe tension headache from Giant Cell Arteritis? Severe headache, not a migraine, lasting 3+ days, extremely tender temples, pulling sensation, neck pain. Worse in the morning. Hot showers, massage only offer short term relief. Taking oxycontin and anti-inflammatories but still have pain and pressure. History of idiopathic polyarthralgia. Diagnosed with 4 cm ascending aortic aneurysm 4 weeks ago after going to ER with chest pain. No heart attack but no cause found. Hesitant to go to ER again as I feel stupid they didn t find anything.