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Tension-type headache in adults: Pathophysiology, clinical features, and diagnosis

Frederick R Taylor, MD
Section Editor
Jerry W Swanson, MD, MHPE
Deputy Editor
John F Dashe, MD, PhD


Tension-type headache (TTH) is the most prevalent headache in the general population [1], and the second-most prevalent disorder in the world [2]. The typical presentation of a TTH attack is that of a mild to moderate intensity, bilateral, nonthrobbing headache without other associated features.

Understanding the pathophysiology and clinical aspects of TTH is important for accurate diagnosis and optimum treatment. However, TTH is a relatively featureless headache, making it the least distinct of all the primary headache phenotypes. In addition, it is the least studied of all the primary headache disorders, despite having a very high socioeconomic impact [1].

This topic will review the classification, pathophysiology, epidemiology, clinical features, and diagnosis of TTH in adults. Treatment is discussed separately. (See "Tension-type headache in adults: Acute treatment" and "Tension-type headache in adults: Preventive treatment".)

Tension-type headache in children is also reviewed separately. (See "Tension-type headache in children".)


There are three main subtypes of TTH:

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Literature review current through: Nov 2017. | This topic last updated: Nov 02, 2017.
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