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Headaches - tension - Risk Factors

Description

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

Risk Factors:

Tension-type headaches are the most common headaches, accounting for nearly half of all headaches. According to one study, nearly 40% of Americans have at least one episode of tension headache during the course of a year. Tension-type headaches are more common among women than men. Some reports estimate that over 85% of women and about 63% of men will have a tension-type headache at some point during a year. Nearly everyone has at least one tension-type headache during their lifetime.

Episodic tension-type headaches are more common than chronic tension-type headaches. Surveys indicate that about 3% of the general population has chronic tension-type headache.

Tension-type headaches are most likely to occur among people in their 40s. The prevalence of tension-type headaches declines as people become older.

Headaches in Children

Headaches are rare before age 4 but increase in prevalence throughout childhood, reaching a peak around age 13. In one large study, about 7% of 7-year olds and 15% of 11-year olds had headaches. Ten percent of these childhood headaches were recurrent. In many of these patients, chronic headaches persist into adulthood. In addition, as adults these patients have a tendency to develop multiple physical or psychiatric complaints, such as back pain, muscle aches, digestive complaints, and depression.

Studies have found that only a minority of chronic childhood headaches are due to physical conditions, such as head injuries or medical problems. Many children with tension-type headache episodes also suffer from some form of emotional disorder.

Psychosocial factors associated with childhood tension-type headaches include:

Sleep problems. Many children who experience chronic daily headaches suffer from sleep disturbances, especially difficulty falling asleep.
Moderate or severe depression.
Emotional rigidity in a child and more repressed anger than their peers.
Family stress. This includes maternal illness or separation, family bereavement, relationship problems, mental illness in a family member, and other stressful family events.
Problems at school. According to a National Headache Foundation survey, nearly 30% of children miss school because of headaches. For many children, the start of the school season can be a particularly stressful time.

The National Headache Foundation recommends these tips for parents:

Keep a diary of child� ' s headaches noting time of onset, length and intensity of attack, location of pain, and food triggers.
Make sure child gets plenty of sleep at regular times.
Avoid changes in child� ' s eating routing (hunger and eating at irregular times can trigger headaches).
Discuss any headache concerns with child� ' s doctor.

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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