Tension-Type Headaches: what can you expect?

According to the International Association of the Study of Pain (IASP), Tension type headaches (TTH) are:

“headache attacks with mild to moderate pain intensity and is often described as having a pressing or tightening (non-pulsating) quality that is not aggravated by routine physical activity, such as walking or climbing stairs. The pain lasts for at least several hours to days and is predominantly felt bilaterally.”

 TTH originates from a combination of tissue sensitivities in the head and neck as well as how the nervous system interprets the signals from those tissues.  Development from episodic to chronic TTH is thought to be accompanied by increasing Central Nervous System sensitivity to the tissue signals like a car alarm that is triggered by a loud truck. Diagnosis of TTH is based on a “featureless” headache and normally results in a neurological examination. Most commonly found are tender spots around the head and neck. Additional diagnostic workup by your doctor is important if you have additional symptoms other than headache.  Chronic TTH is often associated with medication overuse.

Tension-type headache is the most common form of headache. It can be categorized into three subtypes according to the International Classification of Headache Disorders based on headache frequency:

(1) infrequent episodic TTH (<12 headache days/year), (2) frequent episodic TTH (12-180 days/year), and (3) chronic TTH (>180 days/year)

(2) frequent episodic TTH (12-180 days/year)

(3) chronic TTH (>180 days/year).

 Stress seems to play a big role in Tension Headaches. Managing that stress can be beneficial in reducing frequency and duration of these headaches.

According to the International Association of the Study ofPain:

 The lifetime prevalence of episodic TTH is almost 80%, and that of chronic TTH is 3%. Women are slightly more affected than men. The age of onset peaks between 35 and 40 years, and prevalence declines with age in both sexes

o   Headaches are the most prevalent neurological disorders and among the most frequent symptoms seen in general practice.

o   50% of the general population have headaches during any given year, and more than 90% report a lifetime history of headache.

o   The average lifetime prevalence of migraine is 18%, and the estimated average prevalence in the past year is 13%.

o    The prevalence of migraine in children and adolescents is 7.7%.

o   Tension-type headache is more common than migraine, with a lifetime prevalence of about 52%. However, only frequent or chronic tension-type headaches are disabling.

o   3% of the general population have chronic headache, i.e., a headache ≥15 days per month. They are the most severely disabled.

Clinically, this is the most easily and effective type of headache for an RMT to treat. In our experience, after an initial assessment and treatment, future treatments usually should be around 30 minutes 1-3x a week with a follow up in 1-2 weeks depending on severity and chronicity. After your first visit the normal course is of at least a 50-80% resolution of head pain around 30 minutes after the massage treatment. This relief should last from 3 days to 2 weeks and will increase with future treatment.

Make sure to ask for some home care such as exercises and or movements which will depend on the tissues and structures that are sensitized then work together with your Massage Therapist to create a plan of action that is effective and obtainable.