Chronic migraine and chronic tension type headache commonly overlap. 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. If there are any features of migraine, diagnose chronic migraine. Prophylaxis of tension headache selfcare keep a regular schedule of sleep, exercise, and good nutrition. Chronic tension headache is a condition where you have a tension headache on at least 15 days every month for at least three months. Pdf update of chronic tensiontype headache researchgate. Manual palpation of pericranial muscles may reveal abnormal tenderness, the. Treatment of chronic migraine and chronic tensiontype headache. Episodic tension type headache ihs criteria tension type headaches headache has at least 2 of the following criteria. Use of complementary and alternative medicine by patients. Painkillers, taken only when needed for the pain, work well in most cases. Tensiontype headache american family physician aafp. Headache pain can be felt in the head, face or neck. It is estimated that the incidence for chronic tension type headache ctth in the usa is 2.
Tensiontype headache typically causes pain that radiates in. The working mechanism of manual therapy in participants. Chronic tensiontype headache goteborgs universitet. Tension headaches can be difficult to distinguish from migraines. There may be mild nausea with this type of tension type headache. Rearrange your work or study area to avoid physical strain. Tension headache, also known as tension type headache tth or stress headache, is the most common type of primary headache. Chronic tension headache is an uncommon, debilitating form of a tension headache. Tensiontype headache definition tensiontype headache tth is the most common form of headache. Hemicrania continua hc is a distinct clinical entity characterized by constant, unilateral pain that waxes and wanes in severity but never remits completely. The international headache society ihs defines chronic headaches or chronic daily headaches cdh as headaches that affect an individual for 15 or more days in a month, 17 and this affects 4% of the population. Tender points are areas where manual pressure induces local pain, and trigger.
Update of chronic tensiontype headache springerlink. Chronic tension headache causes and treatment patient. Advances in basic pain and clinical research have improved our understanding of pathophysiologic mechanisms of tensiontype headache. Tension type headache is the most common 1 and, as. Sometimes tensiontype headaches occur more than 15 days. Headache itself is a painful and disabling feature of a small number of primary headache disorders, namely migraine, tension type headache, and cluster headache. A recent advance in the field of headache research has been the development of established diagnostic criteria for the various headache types, including tension type headache.
Frequency of recurrent headaches during a cluster headache bout. A variety of strategies can help reduce the severity and frequency of chronic tension headaches without using medicine. According to the 2018 criteria of the international headache society, 1 tension type headaches tth can be classified depending on the temporal frequency of the headaches. Jun 11, 2019 frequent episodic tension headaches may become chronic. For some people, the pain never goes away completely. Gray matter decrease in patients with chronic tension type. Patient leaflets from the bmj group chronic tension headache. Tensiontype headache tth american migraine foundation. They are commonly referred to as stress headaches a tension headache may appear periodically episodic, less than 15 days. If you get more than 15 per month for three or more months, you have chronic tension headaches. If a red flag for a secondary cause of headache is present, magnetic resonance imaging of. In this article, the epidemiology and diagnostic challenges of tth are presented and discussed.
Chronic tension type headache treated with acupuncture, physical training and relaxation training. Increased pericranial tenderness is the most significant. Unlike migraines, tension headaches arent caused by genes. Poor sleeping and eating patterns are triggers for headaches. A patients guide chronic daily headache cdh cdh headache more than 15 days in a month may be caused by chronic migraine, chronic tensiontype headache, chronic cluster headache, hemicrania continua, and new daily persistent headache. About 50% of patients had a headache every day of their lives that may persist for 1030 years or more. Chronic daily headache cdh cdh headache more than 15 days in a month may be caused by chronic migraine, chronic tension type headache, chronic cluster headache, hemicrania continua, and new daily persistent headache. Type headache the normal and most prevalent headache. Central sensitization in tensiontype headache possible. People can get tension type and migraine headaches in response to stressful events or a hectic day these headaches may also be chronic, occurring as frequently as every day.
The lifetime prevalence of episodic tth is almost 80%, and that of chronic tth is 3%. Using mri and voxelbased morphometry, the authors investigated 20 patients with chronic tension type headache ctth and 20 patients with medicationoveruse headache and compared them to 40 controls with no headache history. 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. Effectiveness of manual therapy for chronic tension type headache. If you are affected by headaches that occur 15 or more days per month on average for more than 3 months, see your doctor, who can prescribe medication to help treat and prevent chronic tension type. The most common types of chronic daily headache are chronic migraines and chronic tensiontype headaches. If a sufferer is taking medication daily or almost daily and is receiving little or no relief from the pain, then a physician should be seen for diagnosis and treatment. Medication to prevent headaches may help those who have frequent tension type headaches. Nov 12, 2019 chronic tension headache is an uncommon, debilitating form of a tension headache. Tension type headache tth is the most common type of primary headaches, and its chronic form, chronic tension type headache ctth, is affecting 0. Tensiontype headaches tth are mild to moderate, bilateral episodes that can be. Although the intensity of tensiontype headaches are usually mild or moderate, they can be severe.
Peripheral pain mechanisms are most likely to play a role in 2. A qualitative design with semistructured individual interviews was used. Across included studies, the criteria for chronic headache related to at least 15 days per month was met. Headache can also be caused by or occur secondarily to a long list of other conditions, the most common of which is medicationoveruse headache. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes. Epidemiology of tensiontype headache headache jama. 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. Since 1995 several studies on the treatment of episodic and chronic tension type headache have been published, providing new information on trial methodology for this.
Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. Published estimates of the prevalence of tension type headache vary over a wide range from 1. Tension headache also called tensiontype headache is the common type of headache that most people have at some time. Find out more about the symptoms and treatment here.
About 3% of the general population suffers from chronic headache with female predominance. But if you have chronic tension headache, you have a headache most days. Chronic tension type headache ctth is tension headache attacks that occur more than 15 days per month. Episodic tension type headache, chronic tension type headache introduction the pain is typically pressing or tightening in quality, of mild to moderate intensity, and bilateral in location, and does not worsen with the routine physical activity. Tension type headache is one of the most common primary headache disorders. 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. Nov 22, 2014 tension type headache tth is the most common type of primary headaches, and its chronic form, chronic tension type headache ctth, is affecting 0. Mar 14, 2018 tension headache is the most common form of headache. Tensiontype headache tth is the most common form of headache. Tension type headache is a highly prevalent condition that can be disabling.
Attention to lifestyle factors, such as stress, posture and exercise, may help to prevent headaches. Over the past few decades research on headache has centred on migraine, and much of the best quality evidence for the treatment of tensiontype headache is. Tension headaches are the most common type of headaches among adults. Tension headache is the most common form of headache.
It can be categorized into three subtypes according to the international classification of headache disorders based on headache frequency. In september 2019, the second global patient advocacy summit gpasii was convened to revisit issues from the inaugural meeting in september 2017, assess the progress of the international headache society global patient advocacy coalition ihsgpac in meeting the goals set forth therein, and discuss strategies for achieving established goals and supporting future development. The division of tensiontype headache into episodic and chronic types adopted by the first edition of the international. It can interfere with work, relationships, and daily living.
Tensiontype headache is one of the most common primary headache disorders. Episodic tension type headache, chronic tension type headache. If you have chronic tension headache, you get these headaches a lot. Tension type headaches account for nearly 90% of all headaches. 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.
Executive summary, page 114 at 24 weeks, across 2 rcts, there is moderate. Chronic tensiontype headache 2 2 introduction tension type headache tth is the most common type of headache and has a high socioeconomic impact 1. Guidelines for all healthcare professionals in the. Tension type headaches often occur every day or nearly every day in individuals who seek treatment, but headaches must occur 15 or more days per month for at least 6 months to meet international headache society diagnostic criteria for chronic rather than episodic tension type headache. Pdf effectiveness of manual therapy for chronic tension. Although the mechanism underlying ctth remains unclear, the role of central versus peripheral mechanisms has always been discussed while explaining the pathogenesis of ctth. The most frequent cause of cdh is medication overuse headache or rebound headache. Chronic tension type headache ctth is a cdh fulfilling the criteria for tension type headache. Doctors say you have chronic tension headache if y ou get tension headaches more than 15 da ys a month for at least three months. If your headaches occur 15 or more days a month for at least three months, theyre considered chronic.
Tension type headache is very common, with a lifetime prevalence in the general population ranging in different studies between 30% and 78%. Rest, ice packs or a long, hot shower may be all you need to relieve a tension headache. A tension type headache is the most common type of headache and the one we think of as a normal everyday headache. Management of chronic tensiontype headache with tricyclic. The painfree period between cluster headache bouts. At least 10 episodes fulfilling following criteria headache lasting 30 mins to 7 days has 2 at least 2 of the following bilateral location pressingtightening nonpulsating quality mild or moderate intensity not aggravated by physical activity such as walking or climbing stairs no nausea or vomiting chronic tension type headache is a daily or continuous headache, which may have some variability in the intensity of the pain during a 24hour cycle.
Osteopathic manipulative therapy in patients with chronic. Pain medication, such as aspirin and ibuprofen, are. Primary headache syndromes may generally be distinguished as being either episodic, such as typical migraine or cluster headache, or chronic, such as chronic tension type headache ctth or hemicrania continua. Medication overuse headache american migraine foundation. The diagnosis is based on the history and examination. Less common than tension type headaches, migraines affect approximately 25 to 30 million people in the united states and cause considerably more. A medicine called amitriptyline may help to prevent the headaches from occurring. Tension headache diagnosis and treatment mayo clinic. Medicationoveruse headache moh is a chronic daily headache and a secondary disorder in which acute medications used excessively causes headache in a headache prone patient. Tension headache is the most common type of headache affecting about 40% of the canadian population.
Chronic tension type headache same as tension type headache, except number of days with such headaches. Advances in basic pain and clinical research have improved our understanding of pathophysiologic mechanisms of tension type headache. Chronic is a word doctors use to descr ibe any medical condition that people liv e with for a long time. Treatment of chronic migraine and chronic tension type headache draft evidence report.
Tension type headaches are the most common type of headache worldwide across all age groups. Tension headache also called tension type headache is the common type of headache that most people have at some time. For example, move computer screens to eye level, lower your chair. To date, there have been few well designed, placebocontrolled trials of therapies for chronic tensiontype headache. Treatment of chronic migraine and chronic tensiontype. Medication to prevent headaches may help those who have frequent tensiontype headaches. This type of tension headache lasts hours and may be continuous. A patient can therefore fulfil all criteria for both these diagnoses. Severe cases of tension headache may accompany nausea and vomiting. Pathophysiology of tensiontype headache springerlink.
May 06, 2018 chronic tension headaches come and go over a longer period of time. As many as 90% of adults have had tension type headache these headaches are typically a steady ache rather than a throbbing one, and affect both sides of the head distracting but usually not debilitating. This study aimed to explore which strategies adolescents use to cope with chronic tension. The most common types of chronic daily headache are chronic migraines and chronic tension type headaches. It may feel like a constant ache that affects both sides of the head. Chronic tension type headache 2 2 introduction tension type headache tth is the most common type of headache and has a high socioeconomic impact 1. What is chronic tension headache and who is affected by it.
Apr 16, 2018 chronic tension headache is a condition where you have a tension headache on at least 15 days every month for at least three months. Tension type headache definition tension type headache tth is the most common form of headache. So they prefer to call them tension type headaches. Only patients with ctth demonstrated a significant gray matter decrease in regions known to be involved in pain processing. Pdf tensiontype headache tth is the most common type of primary headaches, and its chronic form, chronic tensiontype headache. It is also one of the most neglected headache types and 2, in its chronic form, chronic tension type headache ctth is one of the most difficult types of headache to treat 1. Pericranial muscle tenderness is the most common finding in both episodic etth and cttth. Jan 12, 2008 chronic tension type headache is less common, affecting about 3% of the general population but accounting for over half of those who have headache more than 180 days a year.