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Tension-type headache.

Sait Ashina1,2, Dimos D Mitsikostas3, Mi Ji Lee4

  • 1BIDMC Comprehensive Headache Center, Department of Neurology and Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA. sashina@bidmc.harvard.edu.

Nature Reviews. Disease Primers
|March 26, 2021
PubMed
Summary
This summary is machine-generated.

Tension-type headache (TTH), a common neurological disorder, is diagnosed via history and excluding other causes. While simple analgesics treat acute pain, preventive options like amitriptyline are key for chronic TTH management.

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Area of Science:

  • Neurology
  • Pain Medicine

Background:

  • Tension-type headache (TTH) is the most common neurological disorder globally.
  • Characterized by mild-to-moderate, bilateral, pressing/tightening head pain, not worsened by physical activity.
  • Diagnosis relies on clinical history and excluding other conditions per the International Classification of Headache Disorders (ICHD-3).

Purpose of the Study:

  • To summarize the current understanding and management of Tension-type Headache.
  • To highlight the diagnostic criteria and treatment strategies for TTH.
  • To underscore the need for increased research and resource allocation for TTH.

Main Methods:

  • Review of diagnostic criteria from the International Classification of Headache Disorders, third edition.
  • Analysis of current pharmacological and non-pharmacological treatment approaches for TTH.
  • Discussion of the underlying pathophysiology, including peripheral mechanisms and central sensitization.

Main Results:

  • TTH diagnosis is primarily clinical, based on patient history and exclusion of other headache types.
  • Simple analgesics are effective for acute TTH treatment.
  • Preventive strategies for chronic TTH include medications like amitriptyline, venlafaxine, mirtazapine, and non-pharmacological therapies.

Conclusions:

  • Despite its prevalence, research progress in TTH has been limited due to insufficient attention and funding.
  • Effective management involves acute treatment with simple analgesics and preventive therapies for frequent or chronic cases.
  • Further scientific and industrial investment is crucial to advance TTH understanding and treatment.