Tension type headaches are commonly seen problems now-a-days. Females have little more preponderance than males. Episodic tension type headaches affects all age ages and both sexes. It is related to fatigue and stress. Previously known as psychogenic headache, stress headache, psychomyogenic headache. The pain is a constant ache usually bilateral in location. It is probably mediated by sustained contraction of muscles attached to the skull. Nausea and vomiting are usually absent which are frequently present in migraine.
Triggering Factors
• Stress
• Depression
• Lack of sound sleep
• Acid peptic disorders
• Smoking
• Alcohol
• Examination phobia
Symptoms of Tension type headaches
– mild to moderate dull aching headaches may be frontal or any other part of skull one or both sides.
-Photophobia or sensitivity to bright light and loud noise(Phonophobia) may occur.
Types–
It can be episodic or chronic. Episodic can be frequent or infrequent. Infrequent episodic means there are less than 12 episodes per year. Frequent episodic means there are more than 12 episodes per year but less than 180 days per year. Chronic types means occurrence of more than 180 days per year.
Diagnosis–
It is purely clinical. No diagnostic tests are there to confirm its diagnosis. History taking about personal and family history may sometimes clinch the diagnosis. Secondary causes related to structural brain lesions may be associated.
Differentiation from Migraine–
Migraine has some typical features like
1. Migraine is throbbing moderate to severe headache confined to one side of skull.
2. May be associated with aura
3. Associated with nausea and vomiting
When to consult Doctor
• The symptoms are incapacitating daily life activities
• Frequent persisting headaches
• Underlying neurological disorder
• Before starting any pharmacological therapy
Management of Tension Type Headaches
The precipitators should be removed. Stress factors usually aggravate the symptoms. Stressful type A personality people should adopt to relaxing exercises, Yoga and meditation. It has a healing effect in both our body and mind. The underlying neurological disorder if any should be treated as priority. Before starting any medication, physician must be consulted.
Drug therapy is given as when symptoms are out of proportion. Mostly NSAIDs are used like Acetaminophen, Ibuprofen, aspirin etc. Over the counter use of the drugs should be avoided. Because NSAIDs have many side-effects like gastritis, peptic ulcer, acute kidney injury.
