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Headaches - tension - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of common headaches.

Highlights:

What Are Tension-Type Headaches?

Tension-type headaches are the most common type of headache, accounting for about half of all headaches. The pain is usually mild-to-moderate in intensity, with a steady pressing or tightening quality (like a vise being squeezed around the head). The headache is not accompanied by nausea or vomiting, and the pain is not increased by routine physical activity such as walking or climbing stairs. A tension-type headache attack can last anywhere from 30 minutes to an entire week.

Who Gets Tension-Type Headaches?

Women are more likely to get tension-type headaches than men. Nearly everyone will have at least one tension-type headache at some point in their lives. Many people who have migraine headaches also have tension-type headaches.

What Is The Difference Between Tension-Type Headaches and Migraine Headaches?

Migraines and tension headaches have some similar characteristics, but also some important differences:

Migraine pain is usually throbbing and while tension-type headache pain is usually a steady ache
Migraine pain may affect only one side of the head while tension-type headache pain typically affects both sides of the head
Migraine pain, but not tension-type pain, worsens with head movement
Migraine headaches, but not tension-type headaches, may be accompanied by nausea or vomiting, sensitivity to both light and sound, or aura

Treatment

Treatment of tension-type headache focuses on relieving pain when attacks occur, and preventing recurrence of attacks. Most tension-type headache attacks respond to simple over-the-counter pain relievers such as aspirin, ibuprofen (Advil), or naproxen (Aleve).

Patients who have two or more tension-type headache attacks each month should talk to their doctors about preventive therapy. This may include a tricyclic antidepressant, such as amitriptyline (Elavil), combined with behavioral therapies. Behavioral treatment approaches include relaxation therapy, biofeedback, stress management, and cognitive-behavioral therapy.

Resources

www.headaches.org -- National Headache Foundation
www.achenet.org -- American Headache Society
www.aan.com -- American Academy of Neurology
www.ninds.nih.gov -- National Institute of Neurological Disorders and Stroke
www.i-h-s.org -- International Headache Society

References

Antttila P. Tension-type headache in childhood and adolescence. Lancet Neurol. 2006 Mar;5(3):268-274.

Fernandez-de-Las-Penas C, Alonso-Blanco C, Cuadrado ML, Gerwin RD, Pareja JA. Myofascial trigger points and their relationship to headache clinical parameters in chronic tension-type headache. Headache. 2006 Sep;46(8):1264-72.

Fernandez-de-Las-Penas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck mobility, and forward head posture in episodic tension-type headache. Headache. 2007 May;47(5):662-72.

Fumal A, Schoenen J. Tension-type headache: current research and clinical management. Lancet Neurol. 2008; 7(1): 70-83.

Lenaerts ME, Gill PS. At the crossroads between tension-type headache and fibromyalgia. Curr Pain Headache Rep. 2006 Dec;10(6):463-6.

Loder, E. and P. Rizzoli. Tension-type headache. BMJ. 2008; 336(7635): 88-92.

Silver, N. Headache (chronic tension-type). Am Fam Physician. 2007; 76(1): 114-6.

Stovner Lj, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007 Mar;27(3):193-210.

Reviewed last on: 9/9/2008
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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