What Is Tension Headache?

This post was written with Consensus AI Academic Search Engine – please read our Disclaimer at the end of this article. Tension headache, also known as tension-type headache (TTH), is one of the most common types of headaches. It is typically characterized by a bilateral, pressing or tightening pain of mild to moderate intensity, often described as a feeling of a tight band around the head. Unlike migraines, tension headaches are not usually associated with nausea or vomiting, and they do not typically worsen with physical activity2 3.

Pathophysiology

The exact pathophysiology of tension headaches is not fully understood, but it is believed to involve both peripheral and central mechanisms. Peripheral mechanisms include increased pericranial muscle tenderness, which is a common finding in patients with tension headaches. This tenderness is thought to be a source of nociception, contributing to the headache pain3 6. Central mechanisms may involve dysregulation of pain modulation pathways, as evidenced by studies showing that activation of descending inhibitory pathways can be protective against the development of tension headaches2.

Triggers and Risk Factors

Several factors can trigger or exacerbate tension headaches. Common triggers include stress, poor posture, and muscle strain, particularly in the neck and shoulders. Psychological factors such as anxiety and depression are also associated with an increased risk of developing tension headaches1 2. Additionally, activities that involve prolonged periods of concentration or eye strain, such as computer work, can contribute to the onset of tension headaches.

Clinical Features

Patients with tension headaches often report a constant, dull pain that affects both sides of the head. The pain is usually described as a tightness or pressure, rather than a throbbing sensation. Unlike migraines, tension headaches do not typically cause visual disturbances or other neurological symptoms. However, they can be associated with muscle tenderness in the head, neck, and shoulders3 6.

Diagnosis

The diagnosis of tension headache is primarily clinical, based on the patient’s history and symptom description. Key diagnostic criteria include the presence of bilateral head pain, a pressing or tightening quality of pain, mild to moderate intensity, and the absence of aggravation by routine physical activity. Additionally, there should be no significant nausea or vomiting, although mild photophobia or phonophobia may be present3.

Conclusion

Tension headaches are a prevalent and often debilitating condition characterized by bilateral, pressing head pain and associated muscle tenderness. Understanding the triggers, pathophysiology, and clinical features of tension headaches is crucial for accurate diagnosis and effective management. Further research is needed to fully elucidate the underlying mechanisms and improve treatment strategies for this common headache disorder.

Disclaimer

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