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Tension Headache

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

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