The majority of patients who report to the physician with a chief complaint of headache will be diagnosed with tension-type headache, The’ name can be misleading ecause “muscle tension” or “tension from stress” is not
always present, either alone or in combination. Tensiont}pe headache is common in the general population, and most people will experience at least one tension-type headache at some point. ,Chronic tension-type headache is more common in woman. than men. The headache is generally bilateral. It is , frequently bitemporal qr frontal-temporal in distribution, Patients commonly describe their pain as though their head is “in a vice” or a “squeezing hatband” is around their head. Headache can occur with or without “pericranial muscle tenderness” (i.e., tenderness to palpation of the,
masticatory and occipital muscles). To be defined as chronic tenslon-type headache, symptoms must be ‘present greater than 1S days per month. The IHS criteria for tension- type headache are listed in Box 29-7. Treatment of
tension-type headache is commonly with tricyclic or other antidepressants. When tension-type headache OCC in migraineurs, migraine treatments are usually beneficial. Psychosocial factors am often a contributing factor
influencing tension-type headache. In this situation cognitive- behavioral and other psychologic therapies are frequently beneficial.