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February 6, 2012
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Tension Headache

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Tension Headache Overview

More than 10 million people a year visit a doctor or an emergency department because of headache. With a complete history and physical examination, a doctor can correctly diagnose and treat a great majority of headaches.

Tension headache is the most common type of headache.

  • About 69% of men and 88% of womendevelop a tension headache sometime during their lives.

  • Tensionheadache can occur at any age but most commonly begins during adolescence or young adulthood, with the highest frequency among those aged 20-50 years.

  • More than 300 known medical disorders can produce headaches. In 1988, the International Headache Society developed a classification system for headache. Thirteen categories of headache are subdivided into 129 subtypes. Headache types are described as primary or secondary.

    • Primary headaches include migraine, tension-type, and cluster headaches. More than 90% of people who see a doctor for headache pain have one of these types. Primary headaches are usually harmless, but they may come back again and again.

    • Secondary headaches are often the result of some underlying disease, of which head pain is a symptom.

  • The International Headache Society further divides tension headaches into episodic or chronic and on the presence or absence of pericranial muscle tenderness (pain on the outside of the skull).

    • People with episodic tension-type headaches have at least 10 previous headache episodes lasting from 30 minutes to 7 days and occurring fewer than 180 times a year. The headache must have at least 2 of the following characteristics:

      • Pressing/tightening (nonpulsating) quality, located on both sides of the head

      • Mild or moderate intensity

      • Not aggravated by routine physical activity

      • No nausea or vomiting

      • Possible sensitivity to light or sound but not both

    • People with chronic tension-type headache have an average headache frequency of 15 days a month or 180 days a year for 6 months and must also meet the criteria for episodic tension-type headache. In addition, people with chronic tension-type headache must not have another disorder as shown by physical and neurologic examination.

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Tension Headache

What are cluster headaches?

Cluster headache is an uncommon condition characterized by short-lived attacks of sudden, severe pain around one of the eyes. The word cluster is used because these headaches typically come in groups or bunches. A person may have several headaches a day for weeks or months, usually separated by headache-free periods of varying duration. Many more people have migraine or tension headaches than cluster headaches.

The International Headache Society (IHS) classifies cluster headaches as episodic (occurring in cycles) or chronic (long-term without significant breaks).

Episodic cluster headaches are defined as those that occur in periods (clusters) lasting from 7 days to 1 year. Clusters are separated by headache-free intervals lasting at least 2 weeks. Clusters usually last 2 weeks to 3 months.

Chronic cluster headach...

Read the Cluster Headache FAQs article »


Read What Your Physician is Reading on Medscape

Headache, Tension »

The International Headache Society (IHS) began developing a classification system for headaches in 1985.

Read More on Medscape Reference »

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