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Concept
Tension headache
Summary
Tension headache, also known as stress headache, or tension-type headache (TTH), is the most common type of primary headache. 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. Tension-type headaches account for nearly 90% of all headaches.
Pain medications, such as paracetamol and ibuprofen, are effective for the treatment of tension headache. Tricyclic antidepressants appear to be useful for prevention. Evidence is poor for SSRIs, propranolol and muscle relaxants.
The 2016 Global Burden of Disease study revealed that TTHs affect about 1.89 billion people and are more common in women than men (30.8% to 21.4% respectively). TTH was most prevalent between ages 35 and 39. Despite its benign character, tension-type headache, especially in its chronic form, can impart significant disability on patients as well as burden on society at large. In 2016, the global burden of TTH was reported to be 7.2 million years of life lived with disability (YLDs). The YLD was calculated using TTH prevalence and average time spent with TTH multiplied by percentage health loss caused by TTH (3.7%).
According to the third edition of the International Classification of Headache Disorders, the attacks must meet the following criteria:
A duration of between 30 minutes and 7 days.
At least two of the following four characteristics:
bilateral location
pressing or tightening (non-pulsating) quality
mild or moderate intensity
not aggravated by routine physical activity such as walking or climbing stairs
Both of the following:
no nausea or vomiting
no more than one of photophobia (sensitivity to bright light) or phonophobia (sensitivity to loud sounds)
Tension-type headaches may be accompanied by tenderness of the scalp on manual pressure during an attack.
Various precipitating factors may cause tension-type headaches in susceptible individuals:
Anxiety
Stress
Sleep problems
Young age
Poor health
Although the musculature of the head and neck and psychological factors such as stress may play a role in the overall pathophysiology of TTH, neither is currently believed to be the sole cause of the development of TTH.
Official source
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