Tension Type Headache
What is Tension Type Headache?
According to the International Headache Society, Tension Type Headache is the most common type of primary headache, which accounts to almost 90% of all headache types. It has a lifetime prevalence worldwide ranging up to 78%.
Tension Type Headache is usually felt by a constant pressing, tightening and squeezing discomfort on both sides of the head. Sufferers normally describe their pain as if they were wearing a tight helmet, which can become tighter and tighter around their head. The pain intensity can range from mild to moderate and can last anywhere between 30 minutes and up to 7 days. Nausea or vomiting is not a feature of tension type headache however, sensitivity to light or sound can be.
Although the pain intensity ranges from mild to moderate, it can still leave those suffering from this condition to become disabled due to the constant, annoying and long lasting nature of this condition.
Types of Tension Type Headache
1. Episodic Tension Type Headache
Episodic Tension Type Headache is characterized by the frequency of attack days per month. It usually occurs if the person suffers less than 15 attack days per month for at least three months. Episodic tension type headache can last anywhere between 30 minutes to 7 days. Recent international research have found the average prevalence is 36% for men and 42% for women. If Episodic tension type headache worsen overtime it may form into chronic tension headache.
2. Chronic Tension Type Headache
Chronic Tension Type Headache is characterized by the frequency of attack days per month. Unlike episodic tension headache, chronic tension headache occurs if the person suffers more than 15 attack days per month for at least three months. For some sufferers they may have a continuous headache that lasts all day for 10-30 years or more. Chronic tension type headache is usually resistant to painkillers, and at times sufferers can also experience migraines in conjunction with their chronic tension headaches.
Tension Type Headache vs Migraine
Tension type headache is different to migraine, and sufferers are often incorrectly diagnosed. Most people may not understand the difference between the two, and often use both terms to label their headaches incorrectly. Tension type headache will have mild to moderate pain, whereas migraine pain is usually more significant and can reach up to severe disabling pain. Tension type headache pain is usually felt bilaterally on both sides of the head, whereas migraine pain is unilaterally and felt on one side of the head. Tension type headache does not get worse with normal every day-to-day activities and movements, however unlike migraine, simple movements, activities, work or even sport can often exacerbate and worsen a migraine.
Below is a table to distinguish between Tension Type Headache and Migraine.
|Tension Type Headache||Migraine|
|Pain is bilaterally and all over||Pain is unilaterally and on one side|
|Pain is mild to moderate||Pain is moderate to severe|
|Pain is felt like a squeezing, tightening, pressure pain||Pain is felt like a severe throbbing and pulsating pain|
|No nausea or vomiting||Nausea and vomiting is often present|
|Movement and activities does not worsen the headache||Movement and activities can worsen the migraine|
|No visual disturbances||Visual disturbances|
|Occurs without warning||Can occur with warning signs or aura|
What is the cause of Tension Type Headache?
The traditional and old theory of the cause of Tension Type Headache was due to an increase in muscular tension around the head and scalp causing a tension type headache. This theory was proved wrong in recent studies, as researchers have found the tension in the scalp from those with tension headache to be no greater than those who were not suffering from headaches1.
Recent discoveries and research have found the primary contributing factor of Tension Type Headache to be the related to the neck, and predominantly a fault in the upper cervical spine resulting in a SENSITISED BRAINSTEM to induce Tension Headaches. Interestingly, studies as early as in the year 1977 have found through EMG, that the scalp muscle activation did not change, however the muscles around the neck showed increased activity1. Thus, indicating a fault within the neck with those suffering from Tension Headaches rather than tension around the head.
I’ve already tried everything. What else can be done to help Tension Type Headache?
If you suffer from episodic or chronic tension type headache and have tried everything with no relief, we suggest you see a dedicated clinic that deals solely with headaches and migraines. If you haven’t had your brainstem assessed to see whether it is causing your tension type headache, we recommend you get this assessed by a headache clinician.
At the Brisbane Headache and Migraine Clinic™, we see countless amount of patients with Tension Type Headaches and utilise world-class techniques in assessing and treating this problem. A thorough examination of the upper cervical spine is initiated to determine the severity of your SENSITISED BRAINSTEM.
If your symptoms are coming from a sensitised brainstem, treatment can begin immediately and you should expect a significant improvement to occur rapidly in 90% of our patients with Tension Type headache. We expect to observe this within the first 5 treatment consultation. We have treated countless of patients with Chronic Daily Headaches with significant results.
The best part about the treatment is being medication-free, surgery-free and invasive-free.
Watch the video to understand more about Tension Type Headache
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1 Bakal D. A. and Kaganov, J. A. (1977) Muscle Contraction and Migraine Headache: Psychophysiologic Comparison. Headache: The Journal of Head and Face Pain. 17 (5) pp 208-215.