Tension-type headache (TTH) is the most prevalent type of headache across all age groups worldwide. TTH is common, disabling, and associated with medical and psychiatric comorbidities. This review will focus on the epidemiologies of episodic and chronic TTH in various age groups, factors associated with progression and remission, comorbidities, and the burden of TTH.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Headache Classification Subcommittee of the International Headache Society: The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004, 24(Suppl 1):9–160.
• Bendtsen L, Jensen R: Tension-type headache: the most common, but also the most neglected, headache disorder. Curr Opin Neurol 2006, 19:305–309. This article is an excellent review of TTH.
Jensen R: Diagnosis, epidemiology, and impact of tension-type headache. Curr Pain Headache Rep 2003, 7:455–459.
Rasmussen BK, Jensen R, Schroll M, Olesen J: Epidemiology of headache in a general population: a prevalence study. J Clin Epidemiol 1991, 44:1147–1157.
Göbel H, Petersen-Braun M, Soyka D: The epidemiology of headache in Germany: a nationwide survey of a representative sample on the basis of the headache classification of the International Headache Society. Cephalalgia 1991, 14:97–106.
Schwartz BS, Stewart WF, Simon D, Lipton RB: Epidemiology of tension-type headache. JAMA 1998, 279:381–383.
Schwaiger J, Kiechl S, Seppi K, et al.: Prevalence of primary headaches and cranial neuralgias in men and women aged 55-94 years (Bruneck Study). Cephalalgia 2009, 29:179–187.
Solomon GD, Kunkel RS, Frame J: Demographics of headache in elderly patients. Headache 1990, 30:273–276.
Lavados PM, Tenhamm E: Epidemiology of tension-type headache in Santiago, Chile: a prevalence study. Cephalalgia 1998, 18:552–558.
•• Stovner LJ, Hagen K, Jensen R et al.: The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007, 27:193–210. This is an important review of studies documenting headache burden around the globe.
Lyngberg AC, Rasmussen BK, Jørgensen T, Jensen R: Incidence of primary headache: a Danish epidemiologic follow-up study. Am J Epidemiol 2005, 161:1066–1073.
Scher AI, Stewart WF, Liberman J, Lipton RB: Prevalence of frequent headache in a population sample. Headache 1998, 38:497–506.
Castillo J, Muñoz P, Guitera V, Pascual J: Kaplan Award 1998. Epidemiology of chronic daily headache in the general population. Headache 1999, 39:190–196.
Wang SJ, Fuh JL, Lu SR, et al.: Chronic daily headache in Chinese elderly: prevalence, risk factors, and biannual follow-up. Neurology 2000, 54:314–319.
Lu SR, Fuh JL, Chen WT, et al.: Chronic daily headache in Taipei, Taiwan: prevalence, follow-up and outcome predictors. Cephalalgia 2001, 21:980–986.
Prencipe M, Casini AR, Ferretti C, et al.: Prevalence of headache in an elderly population: attack frequency, disability, and use of medication. J Neurol Neurosurg Psychiatry 2001, 70:377–381.
Crystal SC, Grosberg BM: Tension-type headache in the elderly. Curr Pain Headache Rep 2009, 13:474–478.
Benseñor IM, Lotufo PA, Goulart AC, et al.: The prevalence of headache among elderly in a low-income area of São Paulo, Brazil. Cephalalgia 2008, 28:329–333.
Pascual J, Berciano J: Experience in the diagnosis of headaches that start in elderly people. J Neurol Neurosurg Psychiatry 1994, 57:1255–1257.
Camarda R, Monastero R: Prevalence of primary headaches in Italian elderly: preliminary data from the Zabút Aging Project. Neurol Sci 2003, 24(Suppl 2):S122–S124.
Anttila P, Metsähonkala L, Aromaa M, et al.: Determinants of tension-type headache in children. Cephalalgia 2002, 22:401–408.
Ozge A, Bŭgdayci R, Saşmaz T, et al.: The sensitivity and specificity of the case definition criteria in diagnosis of headache: a school-based epidemiological study of 5562 children in Mersin. Cephalalgia 2003, 23:138–145.
Laurell K, Larsson B, Eeg-Olofsson O: Prevalence of headache in Swedish schoolchildren, with a focus on tension-type headache. Cephalalgia 2004, 24:380–388.
• Anttila P: Tension-type headache in childhood and adolescence. Lancet Neurol 2006, 5:268–274. This is a comprehensive review of tension-type headache in children.
•• da Silva Jr A, Costa EC, Gomes JB, et al.: Chronic headache and comorbibities: a two-phase, population-based, cross-sectional study. Headache 2010 Feb 12 (Epub ahead of print). This is a population-based study of temporomandibular disorders and psychiatric comorbidities.
Abu-Arefeh I, Russell G: Prevalence of headache and migraine in schoolchildren. BMJ 1994, 309:765–769.
Abu-Arafeh I: Chronic tension-type headache in children and adolescents. Cephalalgia 2001, 21: 830–836.
Scher AI, Stewart WF, Ricci JA, Lipton RB: Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain 2003, 106:81–89.
Mørk H, Jensen R: Prognosis of tension-type headache: a 10-year follow-up study of patients with frequent tension-type headache [abstract]. Cephalalgia 2000, 20:434.
Hagen K, Vatten L, Stovner LJ, et al.: Low socio-economic status is associated with increased risk of frequent headache: a prospective study of 22718 adults in Norway. Cephalalgia 2002, 22:672–679.
Karwautz A, Wöber C, Lang T, et al.: Psychosocial factors in children and adolescents with migraine and tension-type headache: a controlled study and review of the literature. Cephalalgia 1999, 19:32–43.
Anttila P, Sourander A, Metsähonkala L, et al.: Psychiatric symptoms in children with primary headache. J Am Acad Child Adolesc Psychiatry 2004, 43:412–419.
Gonçalves DA, Bigal ME, Jales LC, et al.: Headache and symptoms of temporomandibular disorder: an epidemiological study. Headache 2010, 50:231–241.
Ciancaglini R, Radaelli G: The relationship between headache and symptoms of temporomandibular disorder in the general population. J Dent 2001, 29:93–98.
Chen Y: Advances in the pathophysiology of tension-type headache: from stress to central sensitization. Curr Pain Headache Rep 2009, 13:484–494.
Wang SJ, Juang KD: Psychiatric comorbidity of chronic daily headache: impact, treatment, outcome, and future studies. Curr Pain Headache Rep 2002, 6:505–510.
Mitsikostas DD, Thomas AM: Comorbidity of headache and depressive disorders. Cephalalgia 1999, 19:211–217.
Puca F, Genco S, Prudenzano MP, et al.: Psychiatric comorbidity and psychosocial stress in patients with tension-type headache from headache centers in Italy. The Italian Collaborative Group for the Study of Psychopathological Factors in Primary Headaches. Cephalalgia 1999, 19:159–164.
Holroyd KA, Stensland M, Lipchik GL, et al.: Psychosocial correlates and impact of chronic tension-type headaches. Headache 2000, 40:3–16.
Juang KD, Wang SJ, Fuh JL, et al.: Comorbidity of depressive and anxiety disorders in chronic daily headache and its subtypes. Headache 2000, 40:818–823.
Cassidy EM, Tomkins E, Hardiman O, O’Keane V: Factors associated with burden of primary headache in a specialty clinic. Headache 2003, 43:638–644.
Marcus DA: Identification of patients with headache at risk of psychological distress. Headache 2000, 40:373–376.
Mongini F, Rota E, Deregibus A, et al.: Accompanying symptoms and psychiatric comorbidity in migraine and tension-type headache patients. J Psychosom Res 2006, 61:447–451.
Breslau N, Schultz LR, Stewart WF, et al.: Headache and major depression: is the association specific to migraine? Neurology 2000, 54:308–313.
Guidetti V, Galli F: Psychiatric comorbidity in chronic daily headache: pathophysiology, etiology, and diagnosis. Curr Pain Headache Rep 2002, 6:492–497.
Jensen R, Stovner LJ: Epidemiology and comorbidity of headache. Lancet Neurol 2008, 7:354–361.
Rasmussen BK, Jensen R, Olesen J: Impact of headache on sickness absence and utilisation of medical services: a Danish population study. J Epidemiol Community Health 1992, 46:443–446.
Schwartz BS, Stewart WF, Lipton RB: Lost workdays and decreased work effectiveness associated with headache in the workplace. J Occup Environ Med 1997, 39:320–327.
Bigal ME, Bigal JM, Betti M, et al.: Evaluation of the impact of migraine and episodic tension-type headache on the quality of life and performance of a university student population. Headache 2001, 41:710–719.
Fuh JL, Wang SJ, Lu SR, et al.: A 13-year long-term outcome of elderly with chronic daily headache. Cephalalgia 2008, 28: 1017–1022.
Lyngberg AC, Rasmussen BK, Jørgensen T, Jensen R: Prognosis of migraine and tension-type headache. Neurology 2005, 65:580–585.
No potential conflicts of interest relevant to this article were reported.
About this article
Cite this article
Crystal, S.C., Robbins, M.S. Epidemiology of Tension-type Headache. Curr Pain Headache Rep 14, 449–454 (2010). https://doi.org/10.1007/s11916-010-0146-2
- Tension-type headache
- Chronic daily headache