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Tension-type headache

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 16 Aug 2025
Last updated: 01 Apr 2025

Summary

Definition

Anamnesis y examen

Principales factores de diagnóstico

  • generalized head pain
  • frontal or occipital head pain
  • nonpulsatile head pain
  • constricting pain
  • normal neurologic examination
Todos los datos

Otros factores de diagnóstico

  • pericranial tenderness
  • sternocleidomastoid muscle tenderness
  • trapezius muscle tenderness
  • temporalis muscle tenderness
  • lateral pterygoid muscle tenderness
  • masseter muscle tenderness
  • photophobia or phonophobia
  • nausea
  • regular analgesic use
  • anxiety and depression
  • somatization
Todos los datos

Factores de riesgo

  • mental tension
  • stress
  • missing meals
  • fatigue
  • lack of sleep
  • somatization
  • female sex
  • age 20-39 years
  • lower socioeconomic status
  • analgesic overuse
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • clinical diagnosis
Todos los datos

Pruebas diagnósticas que deben considerarse

  • CT sinus
  • MRI brain
  • lumbar puncture
  • polysomnography
Todos los datos

Algoritmo de tratamiento

Agudo

acute attack

En curso

chronic symptoms (>7-9 headache days/month)

Colaboradores

Autores

Mark W. Green, MD, FAAN
Mark W. Green

Professor of Neurology, Anesthesiology and Rehabilitation Medicine

Emeritus Director of Headache and Pain Medicine

Icahn School of Medicine at Mount Sinai

New York

NY

Divulgaciones

MWG declares that he has no competing interests.

Rachel Colman, MD

Assistant Professor of Neurology

Icahn School of Medicine at Mount Sinai

New York

NY

Divulgaciones

RC declares that she has no competing interests.

Revisores por pares

Sait Ashina, MD

Assistant Professor of Neurology and Anesthesia

Harvard Medical School

Director of Comprehensive Headache Center

Beth Israel Deaconess Medical Centre

Boston

MA

Divulgaciones

SA has received honoraria from and is a consultant for Abbvie/Allergan, Eli Lilly, Linpharma, Lundbeck, Satsuma, Teva, Theranica, Percept, and Impel NeuroPharma. SA is an author of one of the references in this topic.

Giles Elrington, MBBS (Hons), MD, FRCP

Consultant Neurologist

Barts Health NHS Trust

London

UK

Divulgaciones

GE is involved in a number of clinical trials on multiple sclerosis sponsored by Genzyme, Roche, Teva, Novartis, Biogen, as well as one funded by the MRC. He is also involved in clinical trials sponsored by Allergan, NMT Medical, GlaxoSmithKline (GSK), Bristol-Myers, the UK's Parkinson's Disease Research Group, and Pharmacia. In addition, he has attended lectures, conferences, and symposia with the following companies: GSK, AstraZeneca, MSD, Almirall, Pfizer, Menarini, Allergan, Biogen, Teva, Conference Plus, Infomed, BMJ.

Paul Davies, MA, MD, FRCP

Consultant Neurologist

Northampton General Hospital

Northampton

UK

Divulgaciones

PD declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan 25;38(1):1-211.Texto completo

Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021 Mar 25;7(1):24. Resumen

Bendtsen L, Evers S, Linde M, et al. EFNS guideline on the treatment of tension-type headache - report of an EFNS task force. Eur J Neurol. 2010 Nov;17(11):1318-25.Texto completo  Resumen

Headaches in pregnancy and postpartum: ACOG clinical practice guideline No. 3. Obstet Gynecol. 2022 May 1;139(5):944-72. Resumen

Banzi R, Cusi C, Randazzo C, et al. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headache in adults. Cochrane Database Syst Rev. 2015;(5):CD011681.Texto completo  Resumen

Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016;(4):CD007587.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

  • Diferenciales

    • Chronic migraine
    • Medication overuse headache
    • Sphenoid sinusitis
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  • Guías de práctica clínica

    • Headaches in pregnancy and postpartum: ACOG clinical practice guideline No. 3
    • ACR Appropriateness Criteria: headache
    Más Guías de práctica clínica

  • Folletos para el paciente

    Tension-type headache

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