Most Common Neurological Diagnosis
Tension-type headache (TTH) is the most common neurological diagnosis in the general adult population, with a lifetime prevalence of 78% and affecting approximately 48.9% of people at any given time. 1, 2
Epidemiological Evidence
The evidence consistently demonstrates that TTH dominates neurological diagnoses:
- TTH has a lifetime prevalence of 78% in general adult populations, making it far more prevalent than any other neurological condition 2
- Approximately 30% of the population experiences TTH more than 14 days per year, and 3% suffer chronically (headache at least every other day) 2
- Headache disorders collectively constitute nearly 98% of all primary neurological diagnoses, with TTH being the most prevalent subtype 3
Comparison with Other Common Neurological Conditions
While other neurological conditions are significant, they are substantially less prevalent:
- Migraine, though highly disabling, affects approximately one billion people worldwide but remains less prevalent than TTH 4
- Headache disorders as a category (including migraine and TTH) have a combined lifetime prevalence of 66%, with TTH representing the majority 5
- In specialty settings evaluating vertigo, benign paroxysmal positional vertigo (BPPV) accounts for only 42% of cases in that specific population, which represents a small fraction of overall neurological diagnoses 5
Clinical Characteristics of TTH
TTH is characterized by specific features that distinguish it from other headache types:
- Bilateral location with pressing or tightening (non-pulsatile) quality 1
- Mild to moderate intensity without aggravation by routine physical activity 1
- Absence of nausea, vomiting, or significant photophobia/phonophobia 4
- Recurrent episodes that can be episodic or chronic in nature 1
Demographic Patterns
- Females are more frequently affected than males, showing higher pain sensitivity and greater pericranial muscle tenderness 2
- Young subjects experience TTH more frequently than older individuals 2
- The condition affects people across all socioeconomic statuses and races 3
Clinical Significance
Despite being the most common neurological diagnosis, TTH paradoxically receives the least research attention and resource allocation compared to other headache disorders 1. The condition imposes substantial costs through both direct healthcare expenses and indirect costs from work absenteeism and reduced productivity 5. However, most cases can be effectively managed in primary care settings without specialist referral 3.