In this article, the epidemiology and diagnostic challenges of tth are presented and discussed. Chronic daily tension type headaches affect approximately 3% of the population. Tensiontype headache american family physician aafp. Tension type headache tth is the most prevalent headache type and causes a high degree of disability. The common headache found is tension type headache tth. Tension headache is the most common type of headache people experience. Pdf treatment of tensiontype headache researchgate. Tensiontype headache tth is the most prevalent headache type and causes a high degree of disability. The classification, clinical features, differential diagnosis and treatment of tension type headache are discussed in this paper. Efns guideline on the treatment of tension type headache report of an efns task force. Randomised controlled trials show that combination drugs containing simple analgesics and caffeine are also effective for acute treatment of tensiontype headache. Associated with presence of chronic headache at baseline coexisting migraine not being married sleep problems good prognosis.
Scribd is the worlds largest social reading and publishing site. Nov 21, 2017 the international headache society ihs began developing a classification system for headaches in 1985. But that doesnt mean that the world stops when the pain strikes. Over the past few decades research on headache has centred on migraine, and much of the best quality evidence for the treatment of tension type headache is decades old. Localized or generalized pain can mimic migraine or tension. Start with the basics, including diet, exercise and relaxation. Frequent headaches can interfere with your daily life. The diagnosis is based on the history and examination. Over the past few decades research on headache has centred on migraine, and much of the best quality evidence for the treatment of tension type headache is. Tensiontype headache tth is the most prevalent and costly headache stovner et al. Efns guideline on the treatment of tension type headache external link opens in a new window. Tensiontype headache tth is the most common form of headache. Tensiontype headache is one of the most common primary headache disorders.
Tensiontype headache symptoms, diagnosis and treatment. Guidelines for trials of drug treatments in tensiontype headache 5 found in the ihs classification 1. However, in patients with frequent headaches, biological mechanisms in particular. It can be categorized into three subtypes according to the international classification of headache disorders based on headache frequency. Ea macgregor, tj steiner, ptg davies 3rd edition 1st revision. Objectives describe the 5 histories of headache recognize key elements in acute. There was a negative correlation between the total sf36 and hit6 scores spearmans correlation. Tension headache diagnosis and treatment mayo clinic. Tension type headaches can be either episodic or chronic.
Guideline for primary care management of headache in. Advances in basic pain and clinical research have improved our understanding of pathophysiologic mechanisms of tensiontype headache. Distinguishing between migraine and tensiontype headache. Guidelines for all healthcare professionals in the. Is there an indication for the use of barbituratecontaining analgesic agents in the treatment of pain. Migraine and tension headache guideline kaiser permanente. Tension headaches are the most common type of headaches among adults. Tension headache is the most common type of headache, with a reported lifetime prevalence as high as 78%.
Tension headache migraine headache, including menstrual migraine medication overuse headache also known as rebound headache. Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue. Often, patients will live with headache pain for months or even years before seeking care. 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. Unlike migraine, there is no significant nausea, no vomiting, and a lack of a. This guideline includes diagnosis and treatment of the most common headache types that are managed in primary care. The alberta guideline is intended to assist any primary care practitioner responsible for the assessment and management of headaches in adults. Migraine is the most common primary headache disorder. Tension headache is the most common type of headache affecting about 40% of the canadian population. A tensiontype headache is the most common type of headache and the one we think of as a normal everyday headache. Tension type headache often thought to be the most common headache typebut most people have underlying migraine headache chronic tension type. Patient leaflets from the bmj group chronic tension headache.
About 50% of patients had a headache every day of their lives that may persist for 1030 years or more. This collection features the best content from afp, as identified by the afp editors, on headaches and related issues, including cluster headaches, migraines, tension type headaches, and treatment. Patient leaflets from the bmj group chronic tension headache most people get headaches from time to time. Controversy arises because an electromyogram emg often cannot detect increased resting muscle tension in t. A nonselective amitriptyline, but not a selective citalopram, serotonin reuptake inhibitor is effective in the prophylactic treatment of chronic tension type headache. Unlike migraine, there is no significant nausea, no vomiting, and a lack of aggravation by routine physical activity. 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. Drug and nondrug treatment in tensiontype headache ncbi. The effectiveness of caffeine as an adjuvant to ibuprofen has been documented in investigations of acute pain. Increased excitability of the central nervous system generated by repetitive and sustained pericranial myofascial input may be responsible for the transformation of episodic tension type. Medication overuse headaches medication overuse headache is a state of daily or neardaily refractory headaches resulting from overuse of acute pain medicines by a patient with migraine.
Ibuprofen plus caffeine in the treatment of tension. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes. Schoenenf adepartment of neurology, danish headache centre, glostrup hospital, university of copenhagen, copenhagen, denmark. What is tension headache and who it affected by it. Treatment consists of acute pharmacological, preventive pharmacological, and.
Tensiontype headache tth american migraine foundation. If headaches become more frequent and intense with oral contraceptive use, it is important to inform your clinician. Chronic is a word doctors use to descr ibe any medical condition that people liv e with for a long time. Webmd explains the treatments for tension headaches, including overthecounter drugs, biofeedback, cognitive behavioral therapy, and stress reduction techniques. Tensiontype headache definition tensiontype headache tth is the most common form of headache. Diagnostic classification that forms the basis of guidelines is certainly important for formulating clinical care and treatment policies. Pharmacological and nonpharmacological management of. There may be mild nausea with this type of tensiontype headache. So, if you have a tension type headache, a doctors examination will be normal apart from the muscles around the head perhaps being a little tender when a doctor presses on them.
Find out more about the symptoms and treatment here. Pharmacological and nonpharmacological management of tension. Conclusion a clinical practice guideline for the canadian health care context was created using a guideline adaptation process to assist multidisciplinary primary care practitioners in providing evidenceinformed care for patients with headache. But healthy lifestyle choices can help you head off the pain. May 10, 2019 nearly everyone is familiar with the pain of tension type headaches. Mar 14, 2018 tension headache is a primary headache which means that it is not caused by other conditions.
Guidelines for trials of drug treatments in tensiontype. Tension type headache is not as well studied as migraine and was once thought to be primarily psychogenic. The complete headache chart type symptoms precipitating factors treatment prevention hangover headaches migraine. Tension type headache definition tension type headache tth is the most common form of headache. Recent international studies have shown the average prevalence as 36% for men and 42% for women cf migraine. In some instances, a change in the type of oral contraceptive pill will lessen or alleviate the headaches. Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension type, cluster and medicationoveruse headache writing committee. Jan 12, 2008 randomised controlled trials show that combination drugs containing simple analgesics and caffeine are also effective for acute treatment of tension type headache. They are often correlated with stress, tension and a litany of existing medical conditions. Guidelines for trials of drug treatments in tensiontype headache. Despite these apparently straightforward criteria, and that th is the most frequent headache type in the general population 6, it remains the least characteristic of all headache types, its clinical diagnosis based. In ichdii, the episodic type was further divided into an infrequent type, with headache episodes less than once per month, and a frequent type. The present study aim at studying the effect on tth of various biofeedback technique like emg and. Associated with older age absence of chronic tension type headache at baseline.
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. Unlike migraine, there is no significant nausea, no vomiting, and a lack of ag. May 19, 2017 treatment of chronic migraine and chronic tension. Most people with episodic tension type headaches have them no more than once or twice a month. Usually it causes tightness or pressure in a bandlike area around your forehead and head. Efns guideline on the treatment of tensiontype headache report of an efns task force l. It is a complex disorder where a range of heterogeneous mechanisms are likely to play a role bendtsen and jensen, 2006. Tension type headache tensiontype headache treatment drustvo. It is often less severe than migraine although the symptoms can be bothersome because they could include pressure pain on both sides of the head that may last for several days. Pathophysiology of tensiontype headache springerlink. The treatment of the acute episode in patients with infrequent tth is often straightforward, but in patients with frequent headaches, biological mechanisms, in. Eight and two were diagnosed with tension type and probable tension type headache, respectively. Central sensitization in tension type headache possible pathophysiological mechanisms.
Tension type headache tth is the most prevalent headache type and the one with the highest socioeconomic costs. Referral diagnosis is unclear does not respond to treatment complicated by medication overuse require neuroimaging prognosis. Migraine and tension headache diagnosis and treatment guideline 7 treatment. Both are characterized as dull, aching and nonpulsating pain and affect both sides of the head. Overthecounter or prescription medications may help, but simply taking good care of yourself also can help prevent a pounding headache. Efns guideline on the treatment of tensiontype headache.
Nothing to disclose i will be discussing medications that are off label for headache treatment. Unfortunately, repeated use of overthecounter otc pain relievers can actually cause another type of headache, overuse headaches. Its difficult to say precisely how common, as estimates from different studies have varied wildly, but most people will have a tension headache at some point in their lives. Neurophysiological tests and neuroimaging procedures in nonacute headache. In this webinar we will discussed the causes, symptoms, and treatments for both types. Efns guidelinescme article efns guideline on the treatment of tensiontype headache report of an efns task force l. Possible treatment by use of antiinflammatory drugs, propranolol, or biofeedback.
The guidelines main focus is primary headache disorders eg, migraine, tension type, and cluster headache and medicationoveruse headache. Establishment of an accurate diagnosis is important before initiation of any treatment. Headaches usually occur on daily basis and are frequently resistant to treatment. Treatment of chronic migraine and chronic tensiontype headache. Symptoms include dull, nonpulsatile, bilateral, constricting pain not severe. Its difficult to say precisely how common, as estimates from different studies have varied wildly, but most people will have a tension headache. In other instances, the pill or hormone treatment must be discontinued. Our objectives were to assess this agent in the treatment of tension. Tensiontype headaches tth are mild to moderate, bilateral episodes that can be. Under the diagnostic criteria for tth, patients coded. Despite these apparently straightforward criteria, and that th is the most frequent headache type in the general population 6, it remains the least characteristic of all headache. Guideline for primary care management of headache in adults. Tension type headache is the most widespread headache disorder. There are two general classifications of tension type headache.
The appropriate headache diagnosis must be made before a treatment can be selected. Treatment of chronic migraine and chronic tensiontype headache final evidence report april 14, 2017 health technology assessment program hta washington state health care authority po box 42712 olympia, wa 985042712 360 7255126. Now in its third edition beta version, this system includes a tension type headache tth category, further defined as either episodic or chronic. Tension type headache tth is a common primary headache with tremendous socioeconomic impact. History and exam help to differentiate primary and secondary headaches. A tension type headache is the most common type of headache and the one we think of as a normal everyday headache. Treatment of chronic migraine and chronic tensiontype. It may feel like a constant ache that affects both sides of the head. This guideline covers advice on the diagnosis and management of tensiontype headache, migraine including migraine with aura and. But if you have chronic tension headache, you have a headache most days. Some people with tension headaches dont seek medical attention and try to treat the pain on their own. There may be mild nausea with this type of tension type headache. They are commonly referred to as stress headaches a tension headache may appear periodically episodic, less than 15 days.
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