ABSTRACT
Tension-type headache (TTHA), with or without secondary medication overuse headache (MOH), is probably the most common primary headache disorder seen by primary care physicians and neurologists, and, when chronic, by headache specialists. The diagnostic criteria of TTHA, according to the International Headache Society indicate that episodic TTHA is recurrent headache occurring fewer than 15 days a month, lasting from 30 minutes to seven days. Unlike migraine headache patients, TTHA patients can typically carry on with their activities. Most take some form of analgesic, frequently on a daily basis. Without question, TTHA patients may also have migraine, as well as analgesic rebound or MOH. Episodic TTHA appears to have more input from peripheral pain mechanisms, while abnormalities in central pain mechanisms appear to be more important in CTTHA. Patients with TTHA will also endure elements of depression and anxiety. Pathologic changes in the musculoskeletal system may initiate, modulate, or perpetuate TTHA.
