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Tension-type headache
Paul J Millea1, Jonathan J Brodie
1Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee 53226-0509,USA. pmillea@mail.mcw.edu
American Family Physician
|September 27, 2002
Summary
Tension-type headaches present as bilateral, band-like pain without migraine features. Overuse of pain relievers can lead to chronic daily headaches, necessitating careful evaluation for severe cases.
Area of Science:
- Neurology
- Pain Medicine
Background:
- Tension-type headache (TTH) is characterized by bilateral, band-like pain, often described as tightness or pressure, radiating from the forehead to the occiput.
- Unlike migraines, TTH lacks unilateral, throbbing pain, nausea, or photophobia.
Purpose of the Study:
- To review the diagnostic considerations and treatment strategies for tension-type headaches.
- To emphasize the importance of evaluating severe or frequent headaches for underlying serious conditions.
Main Methods:
- Review of typical clinical presentation and diagnostic criteria for TTH.
- Discussion of pharmacological and non-pharmacological treatment options.
- Assessment of risks associated with medication overuse and chronic headache development.
Main Results:
- Neuroimaging is generally not required for TTH without concerning examination findings.
- Over-the-counter analgesics are primary treatment; overuse (more than twice weekly) risks chronic daily headache.
- Amitriptyline is a well-researched prophylactic option; non-medication therapies like biofeedback and relaxation training lack extensive trial data.
Conclusions:
- Careful evaluation is crucial for frequent or severe headaches to rule out serious causes.
- Judicious use of analgesics and consideration of prophylactic agents like amitriptyline are key in managing TTH.
- Non-medication therapies may offer benefits but require further rigorous research.