Headache Education > Tension Headaches

Tension headaches are extremely common but are rarely severe enough to be disabling. Tension-type headaches are generally less severe than migraines but, because of the larger number of people who have them, cause a significant societal cost in productivity and health care costs. In any given year approximately 40% of Americans suffer at least one tension type headache. Studies in Europe indicate that the lifetime chance of having tension type headaches is 2 out of 3 for a man and 9 out of 10 for a woman. These headaches are the most common type of primary headache (a headache not caused by some other systemic illness.) Tension-type headaches are generally less severe than migraine headaches. If a patient has both tension headaches and migraine, then the tension headaches are part of the patient's migraine disease and all of the patient's headaches are really a form of their migraines. If this is you, then stop reading this section and go to the migraine section.

Tension headaches were once called muscle contraction headaches but the medical community now feels they have essentially nothing to do with muscle contraction. They were also once called stress tension headaches, implying that they were a psychological condition, but it is now known that this is not the case. Stress can make tension headaches worse, but does not cause them.

There are two classifications of tension headaches: episodic and chronic. Tension headaches are classified as chronic when a patient has had at least 15 headache days per month for 6 months. Chronic tension headaches may also be accompanied by nausea, but both classifications of tension headaches lack the throbbing quality associated with migraines.

It is very uncommon for tension headache patients to need to see a physician for their headaches. When migraine patients see a physician, a large percentage of them are misdiagnosed as migraine. When the "Spectrum Study" tracked severe tension type headaches over time with an active diary system - 30% of the patients really had migraines. What makes this especially surprising is that these patients had all been diagnosed by the best headache specialists available. Therefore, it is essential that all tension headache patients who get disability with their headaches to keep an active headache diary like iHeadache to verify their diagnosis.