What are the other Names for this Condition? (Also known as/Synonyms)

• Chronic TTH

What is Chronic Tension-type Headache? (Definition/Background Information)

• Chronic Tension-type Headache is a form of tension-type headache (TTH). TTH is a frequently observed condition affecting a wide age range of individuals and having a high prevalence rate among the common population
• Tension-type headache is head pain that occurs from stress or tension leading to a feeling of tightness around the neck and head region. It is one of the most common types of headache and women are more prone to the condition
• In Chronic Tension-type Headache, the mild-to-moderate intensity headaches last from a few hours to a few days, affect both sides of the head, occur very frequently (almost daily), and the affected individual may have increased sensitivity to light or sound
• Per ICHD classification, the subtypes of Chronic TTH include:
  • Chronic Tension-type Headache associated with Pericranial Tenderness
  • Chronic Tension-type Headache not associated with Pericranial Tenderness
• The condition may be associated with mild nausea. Also, normal physical activity, such as walking, does not worsen Chronic Tension-type Headaches. It is informed that Chronic TTH may be a progression of frequent episodic tension-type headache

The criteria for diagnosis of Chronic Tension-type Headache as outlined by the International Headache Society (IHS) is given below:

• Headache occurring on a minimum of or over 15 days/month on average for over 3 months (a minimum of or more than 180 days/year), fulfilling criteria below
• Lasting from 30 minutes to 7 days
• At least two of the following four characteristics:
  • Bilateral location
  • Pressing or tightening (non-pulsating) quality
  • Mild or moderate intensity
  • Not aggravated by routine physical activity such as walking or climbing stairs
• Both of the following:
  • No more than one of photophobia, phonophobia or mild nausea
  • Neither moderate or severe nausea nor vomiting
• Not better accounted for by another ICHD-3 diagnosis

(Source: International Headache Society Classification ICHD-3, London, United Kingdom)

A differential diagnosis to exclude the following conditions may be necessary:

• Chronic migraine
• New daily persistent headache
• Rebound headache due to overuse of pain medications: In some individuals, a chronic overuse of medications for headaches may result in medication-overuse headache (or rebound headache). In such cases, a thorough neurological examination and/or radiological studies may help appropriately classify the chronic headache. This reclassification of headache may result in a different treatment plan