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Current Understanding of the Pathophysiology and Approach to Tension-Type Headache

  • Headache (R.B. Halker Singh and J. VanderPluym, Section Editors)
  • Published:
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Abstract

Purpose of Review

Description of headache dates back thousands of years, and to date, tension-type headache (TTH) remains the most common form of headache. We will review the history and current understanding of the pathophysiology of TTH and discuss the recommended clinical evaluation and management for this syndrome.

Recent Findings

Despite being the most prevalent headache disorder, TTH pathophysiology remains poorly understood. Patients with TTH tend to have muscles that are harder, more tender to palpation, and may have more frequent trigger points of tenderness than patients without headache. However, cause and effect of these muscular findings are unclear. Studies support both peripheral and central mechanisms contributing to the pain of TTH. Diagnosis is based on clinical presentation, while the focus of evaluation is to rule out possible secondary causes of headache. Treatment options have remained similar over the course of the past decade, with some additional studies supportive of both pharmacological and non-pharmacological options.

Summary

An approach to TTH has been outlined including historical context, evolution over time, and the best evidence regarding our current understanding of the complex pathophysiology and treatment of this disease.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Stephanie J. Steel, Carrie E. Robertson & Mark A. Whealy

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  1. Stephanie J. Steel
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Stephanie Steel declares no conflicts of interest. Mark Whealy receives honoraria as an author for UpToDate. Carrie Robertson receives honoraria as an author for UpToDate and has served on advisory boards for Amgen, Lundbeck, Biohaven, Impel, and Eli-Lilly.

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Steel, S.J., Robertson, C.E. & Whealy, M.A. Current Understanding of the Pathophysiology and Approach to Tension-Type Headache. Curr Neurol Neurosci Rep 21, 56 (2021). https://doi.org/10.1007/s11910-021-01138-7

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