Tension headache

Tension-type headache (TTH)
Other namesTension headache, stress headache
A woman experiencing a tension-type headache
SpecialtyNeurology
Differential diagnosisMigraine

Tension headache, stress headache, or tension-type headache (TTH), is the most common type of primary headache. The pain usually radiates from the lower back of the head, the neck, the eyes, or other muscle groups in the body typically affecting both sides of the head. Tension-type headaches account for nearly 90% of all headaches.

Pain medications, such as paracetamol and ibuprofen, are effective for the treatment of tension headache.[1][2] Tricyclic antidepressants appear to be useful for prevention.[3] Evidence is poor for SSRIs, propranolol and muscle relaxants.[4][5]

The 2016 Global Burden of Disease study revealed that TTHs affect about 1.89 billion people and are more common in women than men (30.8% to 21.4% respectively).[6] TTH was most prevalent between ages 35 and 39. Despite its benign character, tension-type headache, especially in its chronic form, can impart significant disability on patients as well as burden on society at large. In 2016, the global burden of TTH was reported to be 7.2 million years of life lived with disability (YLDs). The YLD was calculated using TTH prevalence and average time spent with TTH multiplied by percentage health loss caused by TTH (3.7%).

  1. ^ Derry S, Wiffen PJ, Moore RA, Bendtsen L (July 2015). "Ibuprofen for acute treatment of episodic tension-type headache in adults". The Cochrane Database of Systematic Reviews. 2015 (7): CD011474. doi:10.1002/14651858.CD011474.pub2. PMC 6457940. PMID 26230487.
  2. ^ Loder E, Rizzoli P (January 2008). "Tension-type headache". BMJ. 336 (7635): 88–92. doi:10.1136/bmj.39412.705868.AD. PMC 2190284. PMID 18187725.
  3. ^ Jackson JL, Shimeall W, Sessums L, Dezee KJ, Becher D, Diemer M, et al. (October 2010). "Tricyclic antidepressants and headaches: systematic review and meta-analysis". BMJ. 341: c5222. doi:10.1136/bmj.c5222. PMC 2958257. PMID 20961988.
  4. ^ Verhagen AP, Damen L, Berger MY, Passchier J, Koes BW (April 2010). "Lack of benefit for prophylactic drugs of tension-type headache in adults: a systematic review". Family Practice. 27 (2): 151–165. doi:10.1093/fampra/cmp089. PMID 20028727.
  5. ^ Banzi R, Cusi C, Randazzo C, Sterzi R, Tedesco D, Moja L (May 2015). "Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headache in adults". The Cochrane Database of Systematic Reviews. 2015 (5): CD011681. doi:10.1002/14651858.CD011681. PMC 6864942. PMID 25931277.
  6. ^ Stovner LJ, Nichols E, Steiner TJ, Abd-Allah F, Abdelalim A, Al-Raddadi RM, et al. (November 2018). "Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016". The Lancet. Neurology. 17 (11): 954–976. doi:10.1016/S1474-4422(18)30322-3. PMC 6191530. PMID 30353868.