Tension-Type Headaches

Tension-type headaches (TTH) are the most common primary headache disorder, with a lifetime prevalence of 78%. Its prevalence varies by age, sex, and continent. In the United States, the 1- year prevalence is estimated to be around 38.3% in adults. In both sexes, the prevalence peaks between the ages of 30 and 39 years (42.3% in men and 46.9% in women) and declines with increasing age. The prevalence of TTH is slightly higher in women in all age, race, and education groups. TTH is much more common in Europe, with various studies reporting a 1-year prevalence of up to 80%, than in Asia or the Americas, where prevalence ranges from 20% to 30%.

The global prevalence of current headache in all ages was found to be 47% for all headache, 38% for TTH, and 10% for migraine. Although migraine is by far the most common diagnosis at the doctor’s offices.

TTH is divided into three subtypes based on attack frequency: an infrequent episodic form, in which headaches occur 1 day or less per month on average; a frequent episodic form, in which headaches occur between 1 to 14 days per month for at least 3 months; and a chronic form with 15 or more headache days per month.

Diagnostic criteria for all three subtypes include at least two of the following pain characteristics: bilateral location, non-pulsating quality, mild or moderate intensity, and lack of aggravation with routine physical activity.

TTH has a greater socioeconomic impact due to its higher prevalence. While

the absenteeism among migraine sufferers is higher than in patients with TTH, those with TTH account for a greater total loss of workdays per year and a higher percentage of decreased work effectiveness

TTH is prevalent in children, adults, and elderly adults across the globe. Psychiatric and physical comorbidities may contribute to the burden, conferring a worse prognosis. Treatment needs to address both headache and associated diagnoses to be effective.