Tension-type headache is a nonspecific headache, which is not vascular
or migrainous, and is not related to organic disease. The most common
form of headache, it may be related to muscle tightening in the back of
the neck and/or scalp. There are two general classifications of tension-type
headache: episodic and chronic, differentiated by frequency and severity
of symptoms. Both are characterized as dull, aching and non-pulsating
pain and affect both sides of the head.
Symptoms for both types are similar and may include:
- Muscles between head and neck contract
- A tightening band-like sensation around the neck and/or head which is a
- Pain primarily occurs in the forehead, temples or the back on head and/or neck.
Types of Tension Headaches
Episodic tension-type headache occurs randomly and is usually triggered
by temporary stress, anxiety, fatigue or anger. They are what most of
us consider "stress headaches." It may disappear with the use
of over-the-counter analgesics, withdrawal from the source of stress or
a relatively brief period of relaxation.
The primary drug of choice for chronic tension-type headache is amitriptyline
or some of the other antidepressants. Antidepressant drugs have analgesic
actions, which can provide relief for headache sufferers. Although a patient
may not be depressed, these drugs may be beneficial. Selecting an antidepressant
is based on the presence of a sleep disturbance. For the patient with
chronic tension-type headaches, habituating analgesics must be strictly
avoided. Biofeedback techniques can also be helpful in treating tension-type