Tension Type Headache

Area of Science:

• Neurology
• Pain Medicine
• Headache Research

Background:

• Tension-type headache (TTH) is the most prevalent primary headache disorder.
• Its pathophysiology and optimal management remain subjects of ongoing debate and clinical challenges.
• Current understanding suggests TTH involves complex interactions between peripheral and central nervous system mechanisms.

Purpose of the Study:

• To critically review current scientific evidence on TTH pathophysiology and management.
• To identify existing knowledge gaps in understanding TTH.
• To discuss evidence-based pharmacological and non-pharmacological treatment strategies.

Main Methods:

• Comprehensive literature review of studies on TTH pathophysiology and treatment.
• Analysis of clinical features and proposed mechanisms, including sensitization.
• Evaluation of scientific evidence for various therapeutic interventions.

Main Results:

• TTH pathophysiology involves both peripheral and central sensitization mechanisms.
• Episodic TTH shows higher peripheral excitability; chronic TTH exhibits central sensitization.
• Muscle hyperalgesia plays a significant role in TTH development and maintenance.

Conclusions:

• Multimodal treatment, combining pharmacological and non-pharmacological approaches, is recommended for TTH.
• Effective management can reduce TTH attack frequency and prevent progression to chronic TTH.
• Further research is needed to fully elucidate TTH pathophysiology and refine treatment strategies.