Tension Headache: Classification

Diagnostic criteria: episodic tension-type headache: International Headache Society (IHS) 2018 (after).

A At least 10 headache episodes at < 1 day/month on average (< 12 days/year) and meeting criteria B – D
B Headache duration ranges from 30 minutes to 7 days.
C Headache has at least two of the following four characteristics:

  1. Bilateral localisation
  2. Pain quality pressing or constricting, not pulsating
  3. Mild to moderate pain intensity
  4. Not aggravated by routine physical activity such as walking or climbing stairs
D Both of the following are satisfied:

  1. No nausea or vomiting
  2. Photophobia (sensitivity to light) or phonophobia (hypersensitivity to sound), but not both
E Not better explained by another ICHD-3 diagnosis.

Diagnostic criteria: chronic tension-type headache: International Headache Society (IHS) 2018 (after).

A Headache occurring for more than 3 months on at least 15 days/month (more than 180 days/year) and meeting criteria B-D.
B The headache lasts for hours to days or may occur without a break.
C Headache has at least two of the following four characteristics:

  1. Bilateral localisation
  2. Pain quality pressing or constricting, not pulsating
  3. Mild to moderate pain intensity
  4. Not aggravated by routine physical activity such as walking or climbing stairs
D Both of the following are satisfied:

  1. At most one is present: Photophobia, phonophobia, or mild nausea.
  2. Neither moderate to severe nausea nor vomiting.
E Not better explained by another ICHD-3 diagnosis.