Introduction

Tension-type headache is form of episodic primary headache.

Epidemiology

  • Incidence: 15000.00 cases per 100,000 person-years
  • Peak incidence: 40-50 years
  • Sex ratio: 1:1
Condition Relative
incidence
Tension-type headache1
Migraine0.33
Carbon monoxide poisoning0.0002
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

NICE produced guidelines on the management of tension-type headache in 2012:
  • acute treatment: aspirin, paracetamol or an NSAID are first-line
  • prophylaxis: NICE recommend 'up to 10 sessions of acupuncture over 5-8 weeks'
  • low-dose amitriptyline is widely used in the UK for prophylaxis against tension-type headache. The 2012 NICE guidelines do not however support this approach '...there was not enough evidence to recommend pharmacological prophylactic treatment for tension type headaches. The GDG considered that pure tension type headache requiring prophylaxis is rare. Assessment is likely to uncover coexisting migraine symptomatology with a possible diagnosis of chronic migraine.'