Tension-type headache is the most common type of primary headache with a lifetime prevalence of up to 78%. However, episodic tension-type headache requires little intervention from medical professionals as it rarely produces significant disability. It usually presents as a low impact, mild to moderate band-like featureless headache.
Patients with frequent episodic tension-type headache (1-15 days of TTH per month) often have co-existing Migraine without aura. Patients should be educated to differentiate between the two disorders and encouraged to use a Headache Diary to record individual episodes so that treatment can be maximised and medication-overuse headache avoided.
I.H.S. Criteria for diagnosing episodic tension-type headache.
A. At least ten episodes occurring < 15 days per month on average and fulfilling criteria B-D.
B. Headache lasting from thirty minutes to seven days.
C. Headache has at least two of the following characteristics:
- Bilateral location
- Pressing, tightening (non-pulsating) quality
- Mild to moderate intensity
- Not aggravated by routine physical activity
D. Both of the following:
- No nausea or vomiting
- No more than one of photophobia or phonophobia
E. Not attributed to another disorder