Episodic Tension-type Headache: Prevention [Clinical Review Discussion]

Headache may be the most common physical complaint of mankind.  Of the headache types, the bulk of research has addressed migraine headache. Far less attention has been paid to episodic tension-type headache (ETTH) although its one year prevalence in the United States has been estimated at 38% (1) compared to approximately 12% for migraine (2).  

ETTHs have been classified as a primary headache which, by definition, “have no apparent organic disease” (3).  Etiology is unknown.  As a result the evidence is limited to primarily observational studies or expert opinion.  Many potential triggers have been identified.  Knowledge of those triggers may be utilized to prevent onset.   

Interestingly the traditional cited cause for tension headaches, muscle tension, has been significantly weakened on the basis of electromyographic studies (4)

Chronic tension headache (5) and migraine headache (6) have both been associated with onset of more frequent ETTH.  Possibly the most important aspect of prevention of ETTH is to reduce the chance of ETTH developing into these more debilitating and quality of life altering forms of headache.