Typically tensiontype headache causes mild to moderate pain, usually on both sides of the head. Pharmacological and nonpharmacological management of tension. Guidelines for all healthcare professionals in the diagnosis. Chronic tensiontype headache 15 days or more of headache per month for 3 months or more. Its especially effective for relieving tight, tender muscles in the back of your head, neck and shoulders. Mild or moderate intensity pain bilateral pain no aggravation by simple physical activity pressing or tight nonpulsating pain c no nauseavomiting. Management of multiple coexistent headache disorders 50 11. For some people, the pain never goes away completely. Lipton, mdb,c headaches are acommon reason for visiting aneurologist, a primary care provider, or an emergency department. These headaches can last from 30 minutes to a few days. This may involve taking medication only when you get the headaches, taking daily medication to prevent them or, sometimes, stopping a medication you are already taking. 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.
Your treating clinician will order tests only if the. The pain of tth is usually described as dull, pressure like, constricting or giving a. A tension type headache is the most common type of headache and the one we think of as a normal everyday headache. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes. Primary headaches the most common types of headache are tension headaches and migraines. Includes getting treatment for depression or anxiety. Managing a tension headache is often a balance between fostering healthy habits, finding effective nondrug treatments and using medications appropriately.
The treatment of tension type headaches can be divided into two broad. There are hundreds of different kinds of headaches, depending on where the pain is located, what the pain is like, and the course of the headache. May 19, 2017 treatment of chronic migraine and chronic tension. Jan 27, 2020 the international headache society has suggested that doctors use the term tensiontype headaches because so many different names have been used for tension headaches. Treatment of chronic migraine and chronic tensiontype. Management of tensiontype headache includes general exercise, stress reduction, treatment of any underlying musculoskeletal problems and analgesia. Chronic tension headache occurs equally in women and men usually related to musculoskeletal spasm of neck and shoulders rebound headaches common from excessive symptomatic medications ie. Patient leaflets from the bmj group chronic tension headache. Painkillers, taken only when needed for the pain, work well in most cases. For some people, it may also provide relief from headache pain.
There is also an increased risk of depression in those with severe headaches headaches can occur as a result of many conditions. Know the different types of headache and their treatment. They are often correlated with stress, tension and a litany of existing medical conditions. Headaches types, causes, symptoms, diagnosis, treatment. Treatment of tensiontype, cluster, and medicationoveruse headache is also outlined. Episodic tension headaches usually begin gradually, and often occur in the middle of the day. Chronic tension headaches happen more than 15 days a month. Tensiontype headache tth is the most prevalent headache type and causes a high degree of disability. There is also an increased risk of depression in those with severe headaches. Headache is the symptom of pain in the face, head, or neck.
Tension type headache tth is the most prevalent headache type and causes a high degree of disability. A tension headache tension type headache is the most common type of headache, and yet its causes arent wellunderstood. Diagnosis and management of headaches in young people and adults. Headache tension type headache c duration 30 minutes to 7 days c at least 2 of the following. The international headache society has suggested that doctors use the term tensiontype headaches because so many different names have been used for tension headaches. As discussed at the outset, most of the patients of infrequent episodic tension type headache will not report to the physicians and usually take overthecounter analgesics. Tensiontype headache is the least studied of the primary headache disorders, despite the fact that it has a tremendous socioeconomic effect. Tensiontype headache is diagnosed exclusively on the basis of the history and somatic and neurological examinations. Use of combination therapies containing either butalbital or opioids for treatment of tensiontype headache is generally not recommended. The most common sources of stress include family, social relationships, friends, work, and school. Tension type headache usually bilateral mild to moderate headache pressure or bandlike pain no associated symptoms no prodrome or aura sufferer usually able to continue with normal activities figure 1 difference between tension type headache and migraine.
Some people say its as if a band is pressing on both sides of their head. Tension type headache pain is usually experienced as a band extending bilaterally back from the forehead across the sides of the head to the occiput and may extend to the posterior. Tensiontype headache tth american migraine foundation. Guideline for primary care management of headache in adults. It can occur as a migraine, tensiontype headache, or cluster headache. The diagnosis and management of chronic migraine in. National institute for health and clinical excellence nice. The estimated lifetime prevalence of headache is 66%.
A tension headache usually feels like an ordinary headache. Looks at managing headaches with overthecounter and prescription medicines. 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. Includes stress reduction and getting sleep and exercise. Deep breathing, biofeedback and behavior therapies. Tension headaches are usually triggered by some type of environmental or internal stress. Pain reliever a pain reliever may be recommended first for the treatment of tension type headache. Frequent episodic tensiontype headache at least 10 episodes of headache occurring on average 114 days per month for more than 3 months. The international headache society ihs began developing a classification system for headaches in 1985. Differentiate primary and secondary headaches recognize the clinical features of migraine, chronic migraine, cluster headache, and trigeminal neuralgia. Tender points are areas where manual pressure induces local pain, and trigger. Of the many types of headaches, the tension headache is by far the most prevalentwith 38% of all males and 48% of all females suffering from this form of headache.
Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. 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. An exception to this would be a headache caused by sleeping in an awkward position, causing a sore neck, or an ache in the face and jaw due to tooth grinding. Mar 14, 2018 tension headaches tend to come on during the day and worsen as the day goes on. Tth comprises headache attacks with mild to moderate pain intensity and is often described as. Aids for management of common headache disorders in. Guideline for primary care management of headache in. Pdf tensiontype headache tth is the most common form of headache, and chronic tensiontype. Oct 07, 2014 pain in the head region is called a headache. Apr 15, 2014 chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. The episodic kind usually starts gradually, often in the middle of the day. For patients with frequent episodic tension type headache, simple analgesics and nsaidss are the mainstays in the acute therapy. Objectives describe the features of common headache disorders, so that appropriate treatment can be initiated.
About 50% of patients had a headache every day of their lives that may persist for 1030 years or more. Symptoms usually subside within a few hours tension headaches are often associated with stress, fatigue or muscle strain. Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. Tension headaches tension headaches are usually felt as a band or across the forehead. Often, patients will live with headache pain for months or even years before seeking care. Guidelines for all healthcare professionals in the. Tension type headache tth is the most prevalent headache type and the one with the highest socioeconomic costs. Diagnostic criteria should address diagnosis and treatment scientifically and practically. Tension headache diagnosis and treatment mayo clinic. The severity of a tension headache increases significantly with its frequency. Headaches can occur as a result of many conditions. Pdf treatment of tensiontype headache researchgate.
It may feel like a constant ache that affects both sides of the head. Treatment of tensiontype headache typically involves the use of overthecounter analgesics. Otc preparations, opioid use, barbiturate combination therapies many patients have mixed headaches. If you have chronic tension headache, you get these headaches a lot. Frequent headaches can affect relationships and employment. The term cervicogenic headache cgh was coined almost 3 decades ago, and the general condition of pain located in the head but originating in the cervical spine was described over 100 years ago. However, in patients with frequent headaches, biological mechanisms.
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. Headache remains the most common cause of neurological consultation in clinical practice for which correct diagnosis and treatment are essential. Diagnose episodic tension type headache if headache attacks are not associated with nausea, and have at least two of the following. Tension headaches dont tend to get worse if you move around. Attention to lifestyle factors, such as stress, posture and exercise, may help to prevent headaches. Chronic migraine represents the more severe end of the migraine spectrum, usually arises out of previous episodic migraine, and is characterized by headache on 15 days a month or more. It can occur as a migraine, tension type headache, or cluster headache.
Aids for management of common headache disorders in primary care. Tensiontype headache tth is the most common form of headache. Activities that put the head and neck in a tense, prolonged posture i. Your teen might have this kind of headache occasionally or chronically more than 15 times a month. Acute treatment tension type headaches that occur less than 15 times per month can usually be treated with a pain reliever. Now in its third edition beta version, this system includes a tensiontype headache tth category, further defined as either episodic or chronic. Chronic tension headache successful treatment usually includes strong emphasis on nonpharmacologic management physical therapy for neck stretching relaxation techniques posture correction heat to neck affected by muscle spasm. May 04, 2020 tension headaches usually cause a mild to moderate ache or pressure in a band across the forehead. So doing something like climbing stairs shouldnt make you feel any worse. A variety of relaxation therapies are useful in coping with. Massage can help reduce stress and relieve tension. Refer to management of tension type headache, below. However, from a pathophysiological perspective much of tension type.
It feels like a tight band or a weight pressing down on your head. Tensiontype headache american family physician aafp. Manual palpation of pericranial muscles may reveal abnormal tenderness. Tension headaches may come and go over days or weeks. Medication to prevent headaches may help those who have frequent tensiontype headaches. The lifetime prevalence of tensiontype headache is between 30% and 78%. Although the intensity of tensiontype headaches are usually mild or moderate, they can be severe.
Comprehensive migraine therapy includes management of lifestyle factors and triggers, acute and prophylactic medications, and migraine selfmanagement strategies. Tensiontype headache tth is the most prevalent headache type and the one with the highest socioeconomic costs. Tension headache is the most common form of headache. The most common types of chronic daily headache are chronic migraines and. The prevalence of cervicogenic headache in the general population is estimated to be between 0. Simple guidelines for the management of tension type headache. Episodic use of aspirin or ibuprofen is usually sufficient. History of episodic migraine ihs history of increasing headache frequency with decreasing average severity of migrainous features over 3 months headache at some time meets ihs criteria for migraine.
Tension type headache is not as well studied as migraine and was once thought to be primarily psychogenic. This is the most common type of headache, but the link with stress is not clear. A tension headache is usually less severe than a migraine, and affects both sides of the head. The pain is usually moderate or mild but sometimes it can be severe. Treatment of chronic migraine and chronic tensiontype headache. Tension headache is the most common type of headache, with a reported lifetime prevalence as high as 78%. For the patient presenting with headache for the first time or with a significant change in headache pattern, the headache history should include information on the following headache onset thunderclap, association with head or neck trauma, previous attacks progression of. The efficacy of the prophylactic drugs is often limited and treatment may be. Headache is one of the most common reasons patients seek help from family physicians. Most headaches that cause a medical visit are benign in nature in that the pain is selflimited and mortality or irreversible morbidity. Importantly, the headache needs to meet migraine diagnostic criteria on only 8 days a month in order to meet chronic migraine diagnostic criteria.
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