They are often correlated with stress, tension and a litany of existing medical conditions. At least 10 episodes of headache occurring on tension headache table 3. A tensiontype headache is the most common type of headache and the one we think of as a normal everyday headache. It can be categorized into three subtypes according to the international classification of headache disorders based on headache frequency. The diagnosis is based on the history and examination.
Tensiontype headache is not as well studied as migraine and was once thought to be primarily psychogenic. For example, move computer screens to eye level, lower your chair. Use of pain relievers more than twice weekly places patients at risk for progression to chronic daily. Tension type headache tth is the most prevalent headache type and causes a high degree of disability. Tension type headaches are classified by the international headache society as chronic tension type headaches when they occur for 15 daysmonth or more and episodic tension type headaches when less than 15 daysmonth. Types of headaches while headaches can be caused by medical conditions, injuries, or infections, they are sometimes not due to a specific disease or other identified medical condition. Jan 12, 2008 how does tension type headache present. Possible treatment by use of antiinflammatory drugs, propranolol, or biofeedback. Tension headache diagnosis and treatment mayo clinic. The pain can radiate from the lower back of the head, the neck, eyes or other muscle groups in the body typically affecting both sides of the head. This type of headache often begins at night and may last for 30 minutes to a few weeks.
Migraine and tensiontype headache in a general population. Tensiontype headache is a term used to describe a headache causing mild to moderate pain that often feels like a tight band across your forehead or pressure around the head and neck. Nov 21, 2017 the international headache society ihs began developing a classification system for headaches in 1985. Although they are uncomfortable, tension headaches usually do not cause any serious problems. Not better accounted for by another ichd3 diagnosis, and transient ischaemic attack has been excluded. Frequent episodic tensiontype headache at least 10 episodes of headache occurring on average 114 days per month for more than 3 months. Acute therapy is effective for episodes of tth, whereas preventive treatment which is indicated for frequent and chronic tthis, on average, not. According to the world health organization and international headache society, up to 78% of the population experiences this type of headache, and 60% of tth sufferers experience reductions in social activity and work capacity.
As the frequency of tensiontype headache increases so commonly does the severity of the pain and the likelihood that the patient will present for treatment. A sample headache diary is included on the back of this handout. The treatment of tension type headaches can be divided into two broad. Drug and nondrug treatment in tensiontype headache ncbi. While acute treatment with simple analgesics is generally helpful, recent data attempting to document the efficacy of preventive therapies are. Chicago tensiontype headache treatment diamond headache.
The following can cause muscle tension and trigger a tension headache. Guidelines for all healthcare professionals in the diagnosis. Guidelines for trials of drug treatments in tension type headache 7 should be performed in accordance with the latest version of the declaration of helsinki. Tension headache, also known as stress headache, is the most common type of primary headache. Tension type headaches are the most common form of headache, occurring in about threequarters of the general population. Guideline for primary care management of headache in adults. Despite the high frequency of tth and the total disability society bears due to this primary headache, treatment has been driven more by anecdote and wordofmouth consensus.
Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. The treatment of the acute episode in patients with infrequent tth is often straightforward, but in patients with frequent headaches, biological mechanisms, in. In the us population, the estimated annual prevalence for episodic tension type headache is 38. Joseph is a 48yearold man with a year history of severe daily headache and a moderate migraine every 2 to 3 months. They can range from the occasional mild headache to daily disabling headaches in some cases. The three most common of those types of primary headaches are tension, cluster, and migraine headaches. Tension type headache definition tension type headache tth is the most common form of headache. Tensiontype headache its mechanism and treatment jmaj 473. At least 10 episodes of headache occurring on pdf for free.
Tension type headache tth is a significant cause of sickness absence and impaired ability at work. Tension headaches are caused by stress, jaw clenching, depression, anxiety, and insomnia. Tension type headache tth is the most ubiquitous headache in the general population, and is one of the most common reasons why overthecounter analgesics are purchased. Jun 11, 2019 a tension headache tension type headache is the most common type of headache, and yet its causes arent wellunderstood. Tensiontype headache merck manuals professional edition. Tensiontype headache is divided into infrequent, frequent, and chronic subtypes, defined by the number of episodes suffered per month. Tender points are areas where manual pressure induces local pain, and trigger. Prophylaxis of tension headache selfcare keep a regular schedule of sleep, exercise, and good nutrition. Learn about tensiontype headaches from the cleveland clinic. Some people with tension headaches dont seek medical attention and try to treat the pain on their own. Tensiontype headache, often accompanied with dull pains originating from the occipital area, shoulder stiffness etc. Tensiontype headache case history bmj best practice. Infrequent episodic tensiontype headache less than one day of headache per month. At least 10 episodes fulfilling following criteria headache lasting 30 mins to 7 days has 2 at least 2 of the following bilateral location pressingtightening nonpulsating quality mild or moderate intensity not aggravated by physical activity such as walking or climbing stairs no nausea or vomiting the basics tensiontype headaches tth are the most common form of headache.
Learn more about tension headaches including their symptoms, causes, diagnosis, and treatment at webmd. Use of pain relievers more than twice weekly places. Understand their causes, symptoms, treatment, and how they can be better. Tth previously just called tension headache is classified as a primary headache according to the international classification of headache disorders. Yearly prevalence rates for episodic tth are approximately 80 percent in men and women. Rearrange your work or study area to avoid physical strain. Pdf stress and tensiontype headache mechanisms researchgate. Tensiontype headache definition tensiontype headache tth is the most common form of headache. Often, patients will live with headache pain for months or even years before seeking care. The use of placebo is justifiable in high quality trials or if the scientific question cannot be resolved without the use of placebo see sections on trial design, 2. The pain of tension headache is on both sides of the head. Nondrug therapies can provide effective treatment for tension type headache. Tension headache is the most common type of headache.
Of the many types of headaches, the tension headache is by far the most prevalentwith 38% of all males and 48% of all females suffering from this form of headache. Treatment of tensiontype headache typically involves the use of overthecounter analgesics. Usually it causes tightness or pressure in a bandlike area around your forehead and head. Very little research has been published on the osteopathic treatment of tth. Jan 27, 2020 an episodic tension type headache may last only 30 minutes. These headaches may be provoked by the stress of everyday life, eyestrain or poor posture. About 50% of patients had a headache every day of their lives that may persist for 1030 years or more. Tension type headache tth is the most common headache in the population. Tension type headache is often accompanied by neck or jaw pain, stress, anxiety andor depression, and these other conditions require treatment as well. Due to its high prevalence in the population, tth causes a high degree of disability.
Managing a tension headache is often a balance between fostering healthy habits, finding effective nondrug treatments and using medications appropriately. Frequent tension type headache may require medical attention and prescription medications, or other forms of management. Unfortunately, repeated use of overthecounter otc pain relievers can actually cause another type of headache, overuse headaches. People with infrequent episodic tensiontype headache are unlikely to seek medical advice.
A tension type headache is the most common type of headache and the one we think of as a normal everyday headache. This is more so because patients with frequent headaches often suffer from both disorders. Tension headache is the most common type of headache, with a reported lifetime prevalence as high as 78%. The pain of a tension type headache is usually mild to moderate and often described as viselike. Patients meeting one of the sets of criteria below may also meet the criteria for 1. Treatment of tension type headache typically involves the use of overthecounter analgesics.
They may recur several times daily for up to 412 weeks and then disappear for months or years. Tension type headache tth is the most common headache and it has been discussed for years without reaching consensus on its pathophysiology, or proper rationale management. For example, a patient may have a migraine that begins with a tensiontype headache and then becomes unilateral, pulsatile, and associated with nausea and photophobia. Tensiontype headache tth american migraine foundation. For patients with frequent episodic tension type headache, simple analgesics and nsaidss are the mainstays in the acute therapy. Tensiontype headache tth is the most prevalent and costly headache stovner et al. In ichdii, the episodic type was further divided into an infrequent type, with headache episodes less than once per month, and a frequent type. Sep 26, 2019 a tension headache is the most common type of headache. A chronic tension type headache typically lasts for part or all of the day for most days of the week. Tensiontype headache tth is the most ubiquitous headache in the general population, and is one of the most common reasons why overthecounter analgesics are purchased.
This website provides free medical books tension headache causes headache and dizziness headache relief migraine essential oil sinus headache essential oils for headaches how to relieve headaches headache treatment. Otherwise, they share the following characteristics. A controlled study combining various techniques, such as massage. It can cause pain behind your eyes and in your head and neck. Tension type headache is not as well studied as migraine and was once thought to be primarily psychogenic.
What is the recommended tension type headache treatment. At least 10 episodes fulfilling following criteria headache lasting 30 mins to 7 days has 2 at least 2 of the following bilateral location pressingtightening nonpulsating quality mild or moderate intensity not aggravated by physical activity such as walking or climbing stairs no nausea or vomiting dec 22, 2014 headaches are a major cause of morbidity. Stricter diagnostic criteria have been suggested for 2. Tensiontypelike headache missing one of the features required to fulfil all criteria for a type or subtype of tensiontype headache coded above, and not fulfilling criteria for another headache disorder.
Tension type headaches tth are recurrent episodes of headache lasting minutes to weeks. People with infrequent episodic tension type headache are unlikely to seek medical advice. Bring the diary with you to your medical visit to help your clinician determine treatment options. Pdf treatment of tensiontype headache researchgate. Guideline on the preventive treatment of chronic migraine, chronic. It may feel like a constant ache that affects both sides of the head. Although a headache may be a warning sign of a more serious problem, this is rare. Tensiontype headaches may be another manifestation of migraine, with pain from the migraine being referred to the back of the neck. The intensity of pain may fluctuate during that time. It is a complex disorder where a range of heterogeneous mechanisms are likely to play a role bendtsen and jensen, 2006. Tension type headaches account for nearly 90% of all headaches. Tension type headache causes mild generalized pain usually viselike without the incapacity, nausea, or photophobia associated with migraine.
Tensiontype headaches the basics tensiontype headaches tth are the most common form of headache. As the frequency of tension type headache increases so commonly does the severity of the pain and the likelihood that the patient will present for treatment. As discussed at the outset, most of the patients of infrequent episodic tension type headache will not report to the physicians and usually take overthecounter analgesics. Tensiontype headache in the hope of excluding migraine that phenotypically resembles tensiontype headache.
Tension type headache danish headache center type headache nonpharmacological and pharmacological treatment lars bendtsen associate professor, md, phd, dr med sci danish headache center, department of neurology glostrup hospital, univers ity of copenhagen, denmark european headache school, belgrade, may, 2012 treatment 1200 bc drawing by p. A tension headache is thought to be due to muscle tightness in the scalp, forehead and the back of the neck. Tension headaches are the most common type of headaches among adults. Tension type headaches have been called by various names over the years, including tension headache, muscle contraction headache. The migraine headaches do not bother him very much, but the daily headaches are debilitating.
You may also feel the neck muscles tighten and a feeling of pressure behind the eyes. Most of these patients are successfully treated by primary care physicians. Now in its third edition beta version, this system includes a tension type headache tth category, further defined as either episodic or chronic. Poor sleeping and eating patterns are triggers for headaches. Tensiontype headache causes mild generalized pain usually viselike without the incapacity, nausea, or photophobia associated with migraine. Guidelines for trials of drug treatments in tensiontype headache. Headaches usually occur on daily basis and are frequently resistant to treatment. Occurs in a large proportion of the population, has little impact on the person and is usually selfmanaged. Tension headache ambulatory care what you need to know. Chronic tension type headache is a serious and often disabling disorder which is frequently refractory to even aggressive treatment programs. Signs and symptoms of a tension headache mild to moderate pain, tightness or pressure around the front of the face, head, or neck.
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