Tension-Type Headaches - The Basics

By Teri Robert, MyMigraineConnection Lead Expert

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Tension-type headaches (TTH) are the most common form of headache. 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.

Tension-type headaches have been called by various names over the years including Tension headache, muscle contraction headache, psychomyogenic headache, stress headache, ordinary headache, essential headache, idiopathic headache and psychogenic headache. Of those names, only "tension headaches" is still fairly frequently used.

As you can see from the names tension-type headaches have been know by, it was at one time thought that the cause of TTH was primarily psychological, caused by the mind or emotions. There have now been studies that strongly suggest a physical (neurobiological) cause.

Symptoms and Diagnostic Criteria of Tension-Type Headaches

Tension-type headaches most commonly last from 30 minutes to seven days. The pain is commonly described as "a band around the head" or vise-like.

The headache has at least two of these characteristics:

  • mild to moderate in intensity
  • occurs on both sides of the head (bilateral)
  • is not made worse by routine activity such as bending over or climbing stairs
  • the pain has a pressing or tightening quality, not throbbing or pulsing

A tension-type headache is not accompanied by nausea or vomiting. It may be accompanied by increased sensitivity to light or sound, but not both.

Types of Tension-Type Headaches

TTH is broken down into three types:

  1. Infrequent Episodic Type TTH: one or fewer episodes per month
  2. Frequent Episodic Type TTH: more than one, but fewer than 15 episodes per month for three or more months
  3. Chronic TTH: more than 15 episodes per month for three or more months. There may be mild nausea with this type of TTH.

Diagnosing Tension-Type Headache

There are no diagnostic tests to confirm tension-type headache. Diagnosis is accomplished by reviewing the patient's personal and family medical history, studying their symptoms, and conducting an examination. Tension-type headache is then diagnosed by ruling out other causes for the symptoms.

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