Management of the tension type headache

Abstract

Tension type headache (TTH) is the most frequent headache among the primary headaches, and it is often encountered by a doctor in routine practice.

The severity of tension type headache is mild to moderate. However, among patients with chronic or frequent episodic tension type headache it often disturbs their QOL (quality of life) in daily livings.

The most important thing in managing TTH is correct diagnosis. In order to reach the proper treatment, it is important to exclude secondary headache, migraine and other primary headaches.

The first line of acute treatment of TTH is administration of the abortive drugs such as NSAIDs and analgesics. However attention must be paid not to administer them loosely because these drugs sometimes induces medication overuse headache (MOH). As a preventive medication, antidepressants such as amitriptyline and muscle relaxants are recommended. It is also important to combine non–medication therapy such as psyco–behavioural therapy, relaxation or physical therapy. Understanding the stress and environmental factors of each case, and their management according to their condition are another important issues.