Guidelines for trials of drug treatments in tensiontype headache 5 found in the ihs classification 1. In this article, the epidemiology and diagnostic challenges of tth are presented and discussed. Unlike migraine, there is no significant nausea, no vomiting, and a lack of ag. Despite the high frequency of tth and the total disability society bears due to this primary headache, treatment has been driven more by anecdote and wordofmouth consensus. The diagnosis is based on the history and examination. Some people with tension headaches dont seek medical attention and try to treat the pain on their own. Tension type headache definition tension type headache tth is the most common form of headache. However, in patients with frequent headaches, biological mechanisms in particular. A tension type headache is the most common type of headache and the one we think of as a normal everyday headache. Efns guideline on the treatment of tensiontype headache report of an efns task force l. There may be mild nausea with this type of tension type headache. Randomised controlled trials show that combination drugs containing simple analgesics and caffeine are also effective for acute treatment of tensiontype headache. Treatment of chronic migraine and chronic tensiontype.
Tensiontype headache symptoms, diagnosis and treatment. Tension headache migraine headache, including menstrual migraine medication overuse headache also known as rebound headache. Associated with older age absence of chronic tension type headache at baseline. The common headache found is tension type headache tth. Tensiontype headache tth is the most prevalent headache type and causes a high degree of disability. About 30 to 80 percent of the adult population in the united states suffers from occasional tension type headaches.
Nov 21, 2017 the international headache society ihs began developing a classification system for headaches in 1985. 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. Tension type headache tth is the most ubiquitous headache in the general population, and is one of the most common reasons why overthecounter analgesics are purchased. Usually it causes tightness or pressure in a bandlike area around your forehead and head. Tension headache is the most common type of headache, with a reported lifetime prevalence as high as 78%.
Scribd is the worlds largest social reading and publishing site. Guidelines for trials of drug treatments in tensiontype. The complete headache chart type symptoms precipitating factors treatment prevention hangover headaches migraine. Recent international studies have shown the average prevalence as 36% for men and 42% for women cf migraine. The alberta guideline is intended to assist any primary care practitioner responsible for the assessment and management of headaches in adults. Tension type headache tth is a common primary headache with tremendous socioeconomic impact. May 10, 2019 nearly everyone is familiar with the pain of tension type headaches.
Chronic daily tension type headaches affect approximately 3% of the population. History and exam help to differentiate primary and secondary headaches. Tension type headache is not as well studied as migraine and was once thought to be primarily psychogenic. Objectives describe the 5 histories of headache recognize key elements in acute. There may be mild nausea with this type of tensiontype headache. Its difficult to say precisely how common, as estimates from different studies have varied wildly, but most people will have a tension headache at some point in their lives. In this webinar we will discussed the causes, symptoms, and treatments for both types. Tensiontype headache american family physician aafp. Guidelines for trials of drug treatments in tensiontype headache.
Tensiontype headache tth american migraine foundation. This guideline covers advice on the diagnosis and management of tensiontype headache, migraine including migraine with aura and. Pharmacological and nonpharmacological management of tension. Start with the basics, including diet, exercise and relaxation. Efns guideline on the treatment of tension type headache external link opens in a new window. Nothing to disclose i will be discussing medications that are off label for headache treatment. Tension headache is the most common type of headache people experience. Guideline for primary care management of headache in.
May 19, 2017 treatment of chronic migraine and chronic tension. In other instances, the pill or hormone treatment must be discontinued. Chronic is a word doctors use to descr ibe any medical condition that people liv e with for a long time. Unlike migraine, there is no significant nausea, no vomiting, and a lack of a. Tension type headache tensiontype headache treatment drustvo. Referral diagnosis is unclear does not respond to treatment complicated by medication overuse require neuroimaging prognosis.
Symptoms include dull, nonpulsatile, bilateral, constricting pain not severe. They are often correlated with stress, tension and a litany of existing medical conditions. Schoenenf adepartment of neurology, danish headache centre, glostrup hospital, university of copenhagen, copenhagen, denmark. There was a negative correlation between the total sf36 and hit6 scores spearmans correlation. A tensiontype headache is the most common type of headache and the one we think of as a normal everyday headache. Despite these apparently straightforward criteria, and that th is the most frequent headache type in the general population 6, it remains the least characteristic of all headache. Treatment of chronic migraine and chronic tensiontype headache final evidence report april 14, 2017 health technology assessment program hta washington state health care authority po box 42712 olympia, wa 985042712 360 7255126.
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. Tension type headaches can be either episodic or chronic. Ibuprofen plus caffeine in the treatment of tension. Frequent headaches can interfere with your daily life. Medication overuse headaches medication overuse headache is a state of daily or neardaily refractory headaches resulting from overuse of acute pain medicines by a patient with migraine.
Tensiontype headaches tth are mild to moderate, bilateral episodes that can be. 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. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes. Tensiontype headache is one of the most common primary headache disorders. Jan 12, 2008 randomised controlled trials show that combination drugs containing simple analgesics and caffeine are also effective for acute treatment of tension type headache. Tension type headache tth is the most prevalent headache type and the one with the highest socioeconomic costs. Diagnostic classification that forms the basis of guidelines is certainly important for formulating clinical care and treatment policies. The effectiveness of caffeine as an adjuvant to ibuprofen has been documented in investigations of acute pain. They are commonly referred to as stress headaches a tension headache may appear periodically episodic, less than 15 days. Efns guideline on the treatment of tension type headache report of an efns task force. Its difficult to say precisely how common, as estimates from different studies have varied wildly, but most people will have a tension headache. Associated with presence of chronic headache at baseline coexisting migraine not being married sleep problems good prognosis.
So, if you have a tension type headache, a doctors examination will be normal apart from the muscles around the head perhaps being a little tender when a doctor presses on them. The classification, clinical features, differential diagnosis and treatment of tension type headache are discussed in this paper. Patient leaflets from the bmj group chronic tension headache most people get headaches from time to time. Pdf treatment of tensiontype headache researchgate. Tension headache diagnosis and treatment mayo clinic. Treatment of chronic migraine and chronic tensiontype headache. Tension headaches are the most common type of headaches among adults. Migraine is the most common primary headache disorder. Tension type headache is the most widespread headache disorder. It is a complex disorder where a range of heterogeneous mechanisms are likely to play a role bendtsen and jensen, 2006. Efns guidelinescme article efns guideline on the treatment of tensiontype headache report of an efns task force l. Tensiontype headache tth is the most common form of headache. Controversy arises because an electromyogram emg often cannot detect increased resting muscle tension in t.
Unfortunately, repeated use of overthecounter otc pain relievers can actually cause another type of headache, overuse headaches. Neurophysiological tests and neuroimaging procedures in nonacute headache. About 50% of patients had a headache every day of their lives that may persist for 1030 years or more. Migraine and tension headache guideline kaiser permanente. The guidelines main focus is primary headache disorders eg, migraine, tension type, and cluster headache and medicationoveruse headache. Migraine and tension headache diagnosis and treatment guideline 7 treatment. 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. Guideline for primary care management of headache in adults.
Both are characterized as dull, aching and nonpulsating pain and affect both sides of the head. Overthecounter or prescription medications may help, but simply taking good care of yourself also can help prevent a pounding headache. Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue. Patient leaflets from the bmj group chronic tension headache. Despite these apparently straightforward criteria, and that th is the most frequent headache type in the general population 6, it remains the least characteristic of all headache types, its clinical diagnosis based.
Most people with episodic tension type headaches have them no more than once or twice a month. Often, patients will live with headache pain for months or even years before seeking care. This collection features the best content from afp, as identified by the afp editors, on headaches and related issues, including cluster headaches, migraines, tension type headaches, and treatment. Efns guideline on the treatment of tensiontype headache. The treatment of the acute episode in patients with infrequent tth is often straightforward, but in patients with frequent headaches, biological mechanisms, in. Headaches usually occur on daily basis and are frequently resistant to treatment. Mar 14, 2018 tension headache is a primary headache which means that it is not caused by other conditions.
What is tension headache and who it affected by it. Guidelines for all healthcare professionals in the. Distinguishing between migraine and tensiontype headache. Central sensitization in tension type headache possible pathophysiological mechanisms. Tension type headache often thought to be the most common headache typebut most people have underlying migraine headache chronic tension type.
Webmd explains the treatments for tension headaches, including overthecounter drugs, biofeedback, cognitive behavioral therapy, and stress reduction techniques. But healthy lifestyle choices can help you head off the pain. Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. In some instances, a change in the type of oral contraceptive pill will lessen or alleviate the headaches. The appropriate headache diagnosis must be made before a treatment can be selected. Find out more about the symptoms and treatment here. Pharmacological and nonpharmacological management of.
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. A nonselective amitriptyline, but not a selective citalopram, serotonin reuptake inhibitor is effective in the prophylactic treatment of chronic tension type headache. But that doesnt mean that the world stops when the pain strikes. Guidelines for all healthcare professionals in the diagnosis and management of migraine, tension type, cluster and medicationoveruse headache writing committee. In ichdii, the episodic type was further divided into an infrequent type, with headache episodes less than once per month, and a frequent type. Advances in basic pain and clinical research have improved our understanding of pathophysiologic mechanisms of tensiontype headache. Tensiontype headache tth is the most prevalent and costly headache stovner et al. Tension type headache tth is the most prevalent headache type and causes a high degree of disability. Our objectives were to assess this agent in the treatment of tension. Pathophysiology of tensiontype headache springerlink.
Treatment consists of acute pharmacological, preventive pharmacological, and. Ea macgregor, tj steiner, ptg davies 3rd edition 1st revision. If headaches become more frequent and intense with oral contraceptive use, it is important to inform your clinician. 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. Eight and two were diagnosed with tension type and probable tension type headache, respectively. Now in its third edition beta version, this system includes a tension type headache tth category, further defined as either episodic or chronic.
Localized or generalized pain can mimic migraine or tension. Tensiontype headache definition tensiontype headache tth 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. Possible treatment by use of antiinflammatory drugs, propranolol, or biofeedback. There are two general classifications of tension type headache. Establishment of an accurate diagnosis is important before initiation of any treatment. Tension headache is the most common type of headache affecting about 40% of the canadian population. Unlike migraine, there is no significant nausea, no vomiting, and a lack of aggravation by routine physical activity. Drug and nondrug treatment in tensiontype headache ncbi. Under the diagnostic criteria for tth, patients coded. It may feel like a constant ache that affects both sides of the head. But if you have chronic tension headache, you have a headache most days. Is there an indication for the use of barbituratecontaining analgesic agents in the treatment of pain.
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