Preferences help
enabled [disable] Abstract
Number of results
2019 | 135 | 14-31
Article title

Tension-type headache – most prevalent, still unknown

Title variants
Languages of publication
Tension-type headaches are the most common type of primary headache disorders. They concern up even to 80% of the population. Despite their usually mild course, they are still a major health problem resulting from the multidimensional etiology of the disease, prevalence, demanding treatment and disregarding the symptoms of patients by doctors. The therapy of tension-type headache, due to its character, sometimes requires cooperation with a psychologist or psychotherapist. The article presents current diagnostic methods as well as methods of treatment - immediate, prophylactic and psychological.
Physical description
  • Faculty of Medicine, Wroclaw Medical University, J. Mikulicza-Radeckiego 5, 50-345 Wroclaw, Poland
  • Faculty of Clinical Psychology, SWPS University of Social Sciences and Humanities, A. Ostrowskiego 30b, 53-238 Wroclaw, Poland
  • [1] Jensen R, Stovner LJ. Epidemiology and comorbidity of headache. The Lancet Neurology 7(4) (2008) 354–61.
  • [2] IHS (Headache Classification Committee of the International Headache Society). The International Classification of Headache Disorders, 3rd edition. Cephalalgia: an international journal of headache 38(1) (2018) 1–211.
  • [3] Chai NC, Rosenberg JD, Lee Peterlin B. The epidemiology and comorbidities of migraine and tension-type headache. Techniques in Regional Anesthesia and Pain Management 16(1) (2012) 4–13.
  • [4] Stovner LJ, Andree C. Prevalence of headache in Europe: A review for the Eurolight project. Journal of Headache and Pain 11 (2010) 289–99.
  • [5] Lyngberg AC, Rasmussen BK, Jørgensen T, Jensen R. Has the prevalence of migraine and tension-type headache changed over a 12-year period? A Danish population survey. European Journal of Epidemiology. 20(3) (2005) 243–9.
  • [6] Lyngberg AC, Rasmussen BK, Jørgensen T, Jensen R. Incidence of primary headache: A Danish epidemiologic follow-up study. American Journal of Epidemiology 161(11) (2005) 1066–73.
  • [7] Yu S, Han X. Update of Chronic Tension-Type Headache. Current Pain and Headache Reports 19 (2015) 469.
  • [8] Falsiroli Maistrello L, Rafanelli M, Turolla A. Manual therapy and quality of life in people with headache . Systematic review and meta-analysis of randomized controlled trials. Current Pain and Headache Reports 23 (2019) 78.
  • [9] Vos T, Allen C, Arora M, Barber RM, Brown A, Carter A, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet 388(10053) (2016) 1545–602.
  • [10] Gustavsson A, Svensson M, Jacobi F, Allgulander C, Alonso J, Beghi E, et al. Cost of disorders of the brain in Europe 2010. European Neuropsychopharmacology 21(10) (2011) 718–79.
  • [11] Ashina M, Stallknecht B, Bendtsen L, Pedersen JF, Galbo H, Dalgaard P, et al. In vivo evidence of altered skeletal muscle blood flow in chronic tension-type headache. Brain 125(2) (2002) 320–6.
  • [12] Andersen S, Petersen MW, Svendsen AS, Gazerani P. Pressure pain thresholds assessed over temporalis, masseter, and frontalis muscles in healthy individuals, patients with tension-type headache, and those with migraine-a systematic review. Pain 156(8) (2015) 1409–23.
  • [13] Fernández-De-Las-Peñas C, Bueno A, Ferrando J, Elliott JM, Cuadrado ML, Pareja JA. Magnetic resonance imaging study of the morphometry of cervical extensor muscles in chronic tension-type headache. Cephalalgia 27(4) (2007) 355–62.
  • [14] Palacios Ceña M, Castaldo M, Kelun W, Torelli P, Pillastrini P, Fernández-de-las-Peñas C, et al. Widespread Pressure Pain Hypersensitivity Is Similar in Women With Frequent Episodic and Chronic Tension-Type Headache: A Blinded Case–Control Study. Headache 57(2) (2017) 217–25.
  • [15] Moskowitz MA, Macfarlane R. Neurovascular and molecular mechanisms in migraine headaches. Cerebrovascular and Brain Metabolism Reviews 5(3) (1993) 159–77.
  • [16] Williamson DJ, Hargreaves RJ. Neurogenic inflammation in the context of migraine. Microscopy Research and Technique 53(3) (2001) 167–78.
  • [17] Benemei S, Nicoletti P, Capone JG, Geppetti P. CGRP receptors in the control of pain and inflammation. Current Opinion in Pharmacology 9(1) (2009) 9–14.
  • [18] Perini F, D’Andrea G, Galloni E, Pignatelli F, Billo G, Alba S, et al. Plasma cytokine levels in migraineurs and controls. Headache 45(7) (2005) 926–31.
  • [19] Schou WS, Ashina S, Amin FM, Goadsby PJ, Ashina M. Calcitonin gene-related peptide and pain: a systematic review. Journal of Headache and Pain. 18(1) (2017) 34.
  • [20] Bach FW, Langemark M, Ekman R, Rehfeld JF, Schifter S, Olesen J. Effect of sulpiride or paroxetine on cerebrospinal fluid neuropeptide concentrations in patients with chronic tension-type headache. Neuropeptides 27(2) (1994) 129–36.
  • [21] Jensen R. Pathophysiological mechanisms of tension-type headache: A review of epidemiological and experimental studies. Cephalalgia 19 (1999) 602–21.
  • [22] Jensen R, Rasmussen BK. Muscular disorders in tension-type headache. Cephalalgia 16(2) (1996) 97–103.
  • [23] Schoenen J, Gerard P, De Pasqua V, Juprelle M. EMG Activity in Pericranial Muscles During Postural Variation and Mental Activity in Healthy Volunteers and Patients With Chronic Tension Type Headache. Headache: The Journal of Head and Face Pain 31(4) (1991) 321–4.
  • [24] Pilarska E, Olszewska A. Temperament traits of children with episodic tension-type headaches. European Journal of Paediatric Neurology 13(4) (2009) 327–31.
  • [25] Ozdemir O, Aykan F, Ozdemir P. Coping Strategies and personality traits in women patients with migraine and tension type headache. Journal of Mood Disorders 4(2) (2014) 59.
  • [26] Aaseth K, Grande RB, Leiknes KA, Benth JŠ, Lundqvist C, Russell MB. Personality traits and psychological distress in persons with chronic tension-type headache. The Akershus study of chronic headache. Acta Neurologica Scandinavica 124(6) (2011) 375–82.
  • [27] Siniatchkin M, Riabus M, Hasenbring M. Coping styles of headache sufferers. Cephalalgia 19(3) (1999) 165–73.
  • [28] Perozzo P, Savi L, Castelli L, Valfrè W, Giudice R Lo, Gentile S, et al. Anger and emotional distress in patients with migraine and tension-type headache. Journal of Headache and Pain 6(5) (2005) 392–9.
  • [29] Nash JM, Thebarge RW. Understanding psychological stress, its biological processes, and impact on primary headache. Headache 46(9) (2006) 1337–86.
  • [30] Kikuchi H, Yoshiuchi K, Ando T, Yamamoto Y. Influence of psychological factors on acute exacerbation of tension-type headache: Investigation by ecological momentary assessment. Journal of Psychosomatic Research 79(3) (2015) 239–42.
  • [31] Puca F, Genco S, Prudenzano MP, Savarese M, Bussone G, Amico D, et al. Psychiatric comorbidity and psychosocial stress in patients with tension-type headache from headache centers in Italy. Cephalalgia 19(3) (1999) 159–64.
  • [32] Da Silva A, Costa EC, Gomes JB, Leite FM, Gomez RS, Vasconcelos LP, et al. Chronic headache and comorbibities: A two-phase, population-based, cross-sectional study. Headache 50(8) (2010) 1306–12.
  • [33] Fielding J, Young S, Martin PR, Waters AM. Headache symptoms consistent with migraine and tension-type headaches in children with anxiety disorders. Journal of Anxiety Disorders 40 (2016) 67–74.
  • [34] Gaul C, Van Doorn C, Webering N, Dlugaj M, Katsarava Z, Diener HC, et al. Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: An observational study. Journal of Headache and Pain 12(4) (2011) 475–83.
  • [35] Jensen RH. Tension-Type Headache – The Normal and Most Prevalent Headache. Headache 58(2) (2018) 339–45.
  • [36] Ashina M, Bendtsen L, Jensen R, Sakai F, Olesen J. Muscle hardness in patients with chronic tension-type headache: Relation to actual headache state. Pain 79(2–3) (1999) 201–5.
  • [37] Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia 24(Suppl 1) (2004) 9–160.
  • [38] Loder E, Rizzoli P. Tension-type headache. The BMJ 336(7635) (2008) 88–92.
  • [39] Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton RB, Scher AI, et al. The global burden of headache: A documentation of headache prevalence and disability worldwide. Cephalalgia 27 (2007) 193–210.
  • [40] Rasmussen BK. Migraine and tension-type headache in a general population: precipitating factors, female hormones, sleep pattern and relation to lifestyle. Pain 53(1) (1993) 65–72.
  • [41] Steiner T, Lange R, Voelker M. Aspirin in episodic tension-type headache: placebo-controlled dose-ranging comparison with paracetamol. Cephalalgia 23(1) (2003) 59–66.
  • [42] Martínez-Martín P, Raffaelli E, Titus F, Despuig J, Fragoso YD, Díez-Tejedor E, et al. Efficacy and safety of metamizol vs. acetylsalicylic acid in patients with moderate episodic tension-type headache: A randomized, double-blind, placebo- and active-controlled, multicentre study. Cephalalgia 21(5) (2001) 604–10.
  • [43] Affaitati G, Martelletti P, Lopopolo M, Tana C, Massimini F, Cipollone F, et al. Use of Nonsteroidal Anti-Inflammatory Drugs for Symptomatic Treatment of Episodic Headache. Pain Practice 17(3) (2017) 392–401.
  • [44] Kulkarni GB, Rao GN, Thennarasu K, Gururaj G. Aspirin for acute episodic tension-type headache in adults. Cochrane Database of Systematic Reviews 12 (2011) 1465–858.
  • [45] Lipton RB, Diener HC, Robbins MS, Garas SY, Patel K. Caffeine in the management of patients with headache. Journal of Headache and Pain 18(1) (2017) 107.
  • [46] Haag G, Diener HC, May A, Meyer C, Morck H, Straube A, et al. Self-medication of migraine and tension-type headache: Summary of the evidence-based recommendations of the Deutsche Migräne und Kopfschmerzgesellschaft (DMKG), the Deutsche Gesellschaft für Neurologie (DGN), the Österreichische Kopfschmerzgesellschaft (Ö. Journal of Headache and Pain 12(2) (2011) 201–17.
  • [47] Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G, Schoenen J. EFNS guideline on the treatment of tension-type headache - Report of an EFNS task force. European Journal of Neurology 17 (2010) 1318–25.
  • [48] Bendtsen L, Jensen R, Olesen J. A non-selective (amitriptyline), but not a selective (citalopram), serotonin reuptake inhibitor is effective in the prophylactic treatment of chronic tension-type headache. Journal of Neurology Neurosurgery and Psychiatry 61(3) (1996) 285–90.
  • [49] Ashina S, Bendtsen L, Jensen R. Analgesic effect of amitriptyline in chronic tension-type headache is not directly related to serotonin reuptake inhibition. Pain 108(1–2) (2004) 108–14.
  • [50] Fumal A, Schoenen J. Tension-type headache: current research and clinical management. The Lancet Neurology 7(1) (2008) 70–83.
  • [51] Manna V, Bolino F, Cicco L Di. Chronic Tension‐Type Headache, Mood Depression and Serotonin: Therapeutic Effects of Fluvoxamine and Mianserine. Headache: The Journal of Head and Face Pain 34(1) (1994) 44–9.
  • [52] Trindade E, Menon D, Topfer LA, Coloma C. Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: A meta-analysis. Canadian Medical Association Journal 159(10) (1998) 1245–52.
  • [53] Banzi R, Cusi C, Randazzo C, Sterzi R, Tedesco D, Moja L. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of migraine in adults. Cochrane Database of Systematic Reviews 4 (2015) 1465–858.
  • [54] Boz C, Altunayoglu V, Velioglu S, Ozmenoglu M. Sertraline versus amitriptyline in the prophylactic therapy of non-depressed chronic tension-type headache patients. Journal of Headache and Pain 4(2) (2003) 72–8.
  • [55] Zissis NP, Harmoussi S, Vlaikidis N, Mitsikostas D, Thomaidis T, Georgiadis G, et al. A randomized, double-blind, placebo-controlled study of venlafaxine XR in out-patients with tension-type headache. Cephalalgia 27(4) (2007) 315–24.
  • [56] Ferguson JM. SSRI antidepressant medications: Adverse effects and tolerability. Primary Care Companion to the Journal of Clinical Psychiatry 3(1) (2001) 22–7.
  • [57] Bendtsen L, Jensen R. Mirtazapine is effective in the prophylactic treatment of chronic tension-type headache. Neurology 62(10) (2004) 1706–11.
  • [58] Watanabe N, Omori IM, Nakagawa A, Cipriani A, Barbui C, McGuire H, et al. Safety reporting and adverse-event profile of mirtazapine described in randomized controlled trials in comparison with other classes of antidepressants in the acute-phase treatment of adults with depression: Systematic review and meta-analysis. CNS Drugs 24(1) (2010) 35–53.
  • [59] Verhagen AP, Damen L, Berger MY, Passchier J, Koes BW. Lack of benefit for prophylactic drugs of tension-type headache in adults: A systematic review. Family Practice 27(2) (2009) 151–65.
  • [60] Lampl C, Marecek S, May A, Bendtsen L. A prospective, open-label, long-term study of the efficacy and tolerability of topiramate in the prophylaxis of chronic tension-type headache. Cephalalgia 26(10) (2006) 1203–8.
  • [61] Stillman MJ, Zajac D, Rybicki LA. Treatment of Primary Headache Disorders with Intravenous Valproate: Initial Outpatient Experience. Headache 44(1) (2004) 65–9.
  • [62] Jackson JL, Kuriyama A, Hayashino Y. Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: A meta-analysis. JAMA - Journal of the American Medical Association 307(16) (2012) 1736–45.
  • [63] Rollnik JD, Tanneberger O, Schubert M, Schneider U, Dengler R. Treatment of tension-type headache with botulinum toxin type A: A double-blind, placebo-controlled study. Headache 40(4) (2000) 300–5.
  • [64] Harden RN, Cottrill J, Gagnon CM, Smitherman TA, Weinland SR, Tann B, et al. Botulinum toxin a in the treatment of chronic tension-type headache with cervical myofascial trigger points: A randomized, double-blind, placebo-controlled pilot study. Headache 49(5) (2009) 732–43.
  • [65] Toldo I, Rattin M, Perissinotto E, De Carlo D, Bolzonella B, Nosadini M, et al. Survey on treatments for primary headaches in 13 specialized juvenile Headache Centers: The first multicenter Italian study. European Journal of Paediatric Neurology 21(3) (2017) 507–21.
  • [66] Jensen R. Diagnosis, epidemiology, and impact of tension-type headache. Current Pain and Headache Reports 7(6) (2003) 455–9.
  • [67] Bruehl S, Carlson CR, McCubbin JA. Two brief interventions for acute pain. Pain 54(1) (1993) 29–36.
  • [68] Blanchard EB, Andrasik F, Ahles TA, Teders SJ, O’Keefe D. Migraine and tension headache: A meta-analytic review. Behavior Therapy 11(5) (1980) 613–31.
  • [69] Ziółkowska AM, Trusz S, Bąbel P. Techniques of behavioral therapy for chronic pain and their effectiveness according to the results of meta-analyses. Postepy Psychiatrii i Neurologii 23(1) (2014) 10–6.
  • [70] Andrasik F. Biofeedback in headache: An overview of approaches and evidence. Cleveland Clinic Journal of Medicine 77(Suppl 3) (2010) S72–6.
  • [71] Leventhal H, Brissette I, Leventhal EA. The common-sense model of self-regulation of health and illness. In: Cameron L, Leventhal H, editors. The self-regulation of health and illness behaviour. London: Routledge; 2003. pp. 42–65.
  • [72] Martin PR, Aiello R, Gilson K, Meadows G, Milgrom J, Reece J. Cognitive behavior therapy for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial. Behaviour Research and Therapy 73 (2015) 8–18.
  • [73] Malone MD, Strube MJ. Meta-analysis of non-medical treatments for chronic pain. Pain 34(3) (1988) 231–44.
  • [74] Melchart D, Streng A, Hoppe A, Brinkhaus B, Witt C, Wagenpfeil S, et al. Acupuncture in patients with tension-type headache: Randomised controlled trial. British Medical Journal 331(7513) (2005) 376–9.
  • [75] Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR. Acupuncture for tension-type headache. Cochrane Database of Systematic Reviews 4 (2016) 1465–858.
  • [76] Torelli P, Jensen R, Olesen J. Physiotherapy for tension-type headache: A controlled study. Cephalalgia 24(1) (2004) 29–36.
  • [77] Posadzki P, Ernst E. Spinal manipulations for tension-type headaches: a systematic review of randomized controlled trials. Complementary Therapies in Medicine 20(4) (2012) 232–9.
  • [78] Cho S, Song T, Chu M. Sleep and Tension-Type Headache. Current Neurology and Neuroscience Reports 19(7) (2019) 44.
Document Type
Publication order reference
YADDA identifier
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.