Although they aren't the type of headache most treated by doctors, tension-type headaches (TTH) are the type most experienced. It's estimated that more than three-quarters of all headaches are tension-type headaches.
What's in a name?
You may have seen these headaches referred to as "tension" headaches and/or "muscle contraction" headaches. "Tension headaches" was first used to suggest that these headaches were the result of psychological stress and tension. Since they are not psychological in nature, that's misleading. "Muscle contraction" was used because increased activity of the pericranial muscles is so often involved. When researchers realized that was true just as often in episodes of migraine disorder, the use of "muscle contraction headache" was pretty much abandoned, and the term "tension-type headache" came into use.
Diagnosis
Unfortunately, as with other headache disorders, there are no definitive diagnostic tests that can be used to say, "Aha! This person has TTH!" Diagnosis is made based on medical history; neurological examination; ruling out organic disorders such as aneurysm, stroke, or brain tumor; the presence of some symptoms and the absence of other symptoms. A key point to remember about diagnosing any headache disorder is that proper diagnosis can be tricky because so many symptoms are common to different disorders. It can take time and an experienced doctor to differentiate between them.
Categorizing TTH
For most people, TTH occurs only periodically, and relief can be achieved with an over-the-counter pain reliever, an ice pack, and perhaps a nap. Massage, meditation, and relaxation exercises are also helpful for some people. When they occur more frequently, however, they acquire slightly different names:
- Episodic Tension-Type Headaches (ETTH) strike at least twice per week, but no more than 15 times per month.
- Chronic Tension-Type Headaches (CTTH) strike more than 15 times per month, nearly daily. Following the diagnostic criteria set by the International Headache Society, this frequency must be observed for a period of six months for a diagnosis of CTTH rather that TTH or ETTH.
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