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Are Tension Headaches Common?

iHeadache Electronic Headache Diary

Unfortunately, there has not been a U.S. telephone randomdigit dial surveyof people who have tension typeheadaches like there has for people with migraine headaches. There have been many European studies that conclude the lifetime chance of developing a period of time of having tension type headaches is 2 out of 3 for a man and 9 out of 10 for a woman. In any given year approximately 40% of Americans suffer at least one tension type headache. These headaches are the most common type of primary headache, which is a headache not caused by some other systemic illness.

Tension-type headaches are generally less severe than migraine headaches but because of the larger number of people who have them, they cause a significant societal cost due to lost productivity and health care costs. This only recently came to light and with future revisions to the International Headache Society (I.H.S.) classification {Cephalgia 2004;24 (Suppl 1)} system, Dr. Loftus feels that improved studies and medical treatment for tension headache patients will come during the next decade, just as improved migraine therapy came during the 1990s.

The epidemiologic (or frequency) data, however, could be in error as demonstrated by one study of patients including those with severe episodic tension-type headaches. In this study, headache experts classified patients as having common migraine, classic migraine, probable migraine and episodic tension-type headaches. Only patients with severe tension type headaches were allowed in the study. The patients were then given diaries to fill out during their actual headaches. Approximately 1 in 3 patients had been improperly classified. One thing this tells us is that epidemiological studies that depend on the patient’s memory can have a high error rate at least in the area of severe tension-type headache.

Chronic tension type headaches are an even more difficult area to determine. Many migraine experts feel that a high percentage of patients whose headaches meet the definition of chronic tension type headaches are actually migraine headache sufferers whose headaches have transformed into chronic daily headaches but the headache has lost many of its migraine qualities. How much of this is part of migraine itself and how much is due to headache medicine overuse (i.e. rebound headache) is not clear. It does appear that up to 4% of Americans suffer from chronic daily headache or near daily headache.