Tension-type Headache

Primary headaches represent some of the most costly diseases in modern society, and epidemiologic studies indicate that tension-type headache and migraine represent two different diseases, although coexisting in many patients. Limited knowledge of the underlying pathophysiology of tension-type headache is not yet available, and there is no specific treatment. In this paper, the clinical presentation of tension-type headache is described, and treatment strategies for the acute episode as well as for the prophylaxis of chronic tension-type headache are summarized. Simple analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute headache and low dose tricyclic antidepressants are still the mainstays of treatment, although new promising therapies are emerging.