Tension headache (SKS; tension-type headache; synonyms: CSK; ESK; tension headache, TTH; ICD-10 G44.2: tension headache) is a mild to moderate headache. They are described as dull and pressing and occur in the area of the entire head, but especially in the area of the temples.
Tension headache is the most common type of headache. It is divided into episodic (occurring occasionally) and chronic (recurring) tension headache:
- Episodic tension headache:
- Sporadic: < 12 headache days/year.
- Frequent: min. 1 x and max. 14 x/month or > 12 and < 180 headache days/year
- Chronic tension headache: at least three months ≥ 15 headache days/month.
Another distinction is whether or not the tension headache is associated with muscle tension in the neck and throat.
Gender ratio: women are affected slightly more often than men. During pregnancy, most women report improvement in tension headache.
Frequency peak: the condition occurs in the 3rd and 4th decades of life and in old age. Children and adolescents are less likely to suffer from tension headaches. However, recurrent tension headache and migraine and their subtypes account for over 90% of headache complaints presented to pediatricians.Chronic tension headache occurs predominantly between the ages of 20 and 24 years and after the age of 64 years.With increasing age, the frequency of episodic tension headache decreases.
The prevalence of chronic tension headache is 0.6%. About one third of Germans suffer from tension headaches from time to time. The lifetime prevalence is 90%.The 1-year prevalence for a sporadic tension headache is 62.6%.
Course and prognosis:Tension headaches are not so severe that they keep the sufferer from daily life. They are comparable to a constant source of disturbance in the background. If episodic tension headache is recognized early, it usually takes a benign course. However, it is associated with an increased risk of chronicity. The development of a chronic tension headache can be prevented by avoiding the precipitating factors and taking preventive measures.
Note: If the headache is frequent or chronic, it must be differentiated from migraine.
Comorbidities (concomitant disorders): chronic tension headache is increasingly associated with depression (51%), panic disorder (22%), dysthymia (chronic depression with less severe depressive symptoms) (8%), and generalized anxiety disorder (1%).
