Tension-Type Headache

Tension-type headache (TTH) is a term generally used to describe a chronic head-pain (headache) syndrome characterized by bilateral tight, band like discomfort. The head pain generally begins and builds slowly, which fluctuates in severity, and may persist continuously for several days. The headache may be episodic or chronic (chronic means headache is present for more then15 days per month).

Tension-type headache is generally not accompanied by features such as nausea, vomiting, photophobia, phonophobia, osmophobia, throbbing of head, and aggravation of headache with movement. It becomes easier to diagnose tension-type headache if the above accompanying features are absent in headache and makes it easier to separates migraine, which has one or more of these features. But, the International Headache Society’s definition of TTH allows nausea, photophobia, or phonophobia in combination with headache as TTH (tension-type headache) and making it difficult to distinguish these two clinical entities (TTH and migraine).

The pathology of tension-type headache is no well understood, but most likely cause is primary disorder of CNS (central nervous system) pain modulation alone, which differentiate tension-type headache from migraine, which involves a more generalized disturbance of sensory modulation. Some studies suggest there is some genetic contribution, but it may not be valid. The term tension-type headache suggests nervous tension as a cause, but there is no clear evidence for tension as an etiology. Muscle contraction has been considered to be a distinguishing feature of TTH from migraine, but there appear to be no differences in contraction between the two headache types.