How is tension headache defined and categorized?

Updated: Nov 21, 2017
  • Author: Michelle Blanda, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

The International Headache Society (IHS) began developing a classification system for headaches in 1985. Now in its third edition (beta version), this system includes a tension-type headache (TTH) category, further defined as either episodic (frequent and infrequent) or chronic. Headache categories also are defined by whether they are associated with pericranial muscle disorders. [1]

Episodic tension headache usually is associated with a stressful event. This headache type is of moderate intensity, self-limited, and usually responsive to nonprescription drugs.

Chronic tension headache often recurs daily and is associated with contracted muscles of the neck and scalp. This type of headache is bilateral and usually occipitofrontal.

TTH is the most common type of chronic recurring head pain. In the past, pain etiology was presumed to be the muscular contraction of pain-sensitive structures of the cranium, but the IHS intentionally abandoned the terms muscular contraction headache and tension headache because no research supports muscular contraction as the sole pain etiology.


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