From the Guidelines
Tension-type headache is diagnosed based on the presence of at least two of the following features: pressing, tightening, or nonpulsatile character, mild to moderate intensity, bilateral location, and no aggravation with routine activity, as well as the absence of nausea, vomiting, photophobia, and phonophobia.
Diagnostic Criteria
The diagnostic criteria for tension-type headache, as outlined by the International Headache Society, include:
- At least two of the following features:
- Pressing, tightening, or nonpulsatile character
- Mild to moderate intensity
- Bilateral location
- No aggravation with routine activity
- Both of the following features:
- No nausea or vomiting (may have anorexia)
- No photophobia and phonophobia (but may have one or the other) 1
Clinical Presentation
Tension-type headache typically involves bilateral, mild to moderate pain with a pressing or tightening quality that is not aggravated by routine physical activity 1.
Differential Diagnosis
It is essential to distinguish tension-type headache from other primary headache disorders, such as migraine and cluster headache, as well as secondary headache disorders, including medication-overuse headache, to ensure proper management and treatment 1.
From the Research
Diagnostic Criteria for Tension-Type Headache
The diagnostic criteria for tension-type headache are characterized by the following features:
- Bilateral location of pain 2, 3, 4
- Pressing or tightening quality of pain 2, 3, 4, 5
- Mild to moderate intensity of pain 2, 3, 4, 5
- No aggravation of pain by routine physical activity 2, 3, 4, 5
- Absence of nausea, vomiting, photophobia, and phonophobia 2, 6, 3, 4
Associated Symptoms
Some studies suggest that associated symptoms such as:
- Mild nausea 3
- Photophobia 6, 3
- Phonophobia 6, 3 may not be exclusion criteria for tension-type headache, but rather important criteria for screening 3
Core Criteria for Screening
Non-pulsating headaches and headaches that are not aggravated by routine physical activity may represent core criteria for screening patients with tension-type headache 3