Tension Headache

       Type Tension headache or tension-type headache is defined as a sensation of heaviness or pressure that settled, on both sides of the head arising episodic and associated with stress, but it can be repeated almost every day without any psychological factors. The pain arises due to continued contraction of the muscles of the head and neck is m. splenius capitis, m. temporalis, m.maseter, m. sternocleidomastoid, m. trapezius, m. posterior cervical, and m. levator scapula.

      The nature of the pain is usually in the form of feeling depressed or tied, from a light-weight, bilateral, not triggered by physical activity and accompanying symptoms are not prominent. Tension headache is also known as stress headache, muscle contraction headache, psychomiogenic headache, ordinary headache, and psychogenic headache.

Etiology
The etiology of tension headaches is not known certainly, but suspected caused by several factors, among others, is the originator of light Dazzling, psychosocial stress, anxiety, depression, muscle stress, anger, surprise, and the use of medications for tension headaches excessive

Muscles of the face, neck and scalp became tense because:
a. anxiety or stress
b. Survive in one position for long periods
c. Injury, such as a car accident
d. Depression
Headache can also be triggered by:
a. Sleeping too less or too much
b. Eating too little or too much
c. Excessive alcohol drinking
d. Working hard indoor or outdoor
e. Certain medical conditions

Classification of tension-type headache / Tension Headache by Ad Hoc,
Committee of the International Headache Society are as follows :

1. Episodic tension-type headache
a. Had at least 10 times the headache episodes , where the number of days headache is < 180 days / year ( < 15 days / month )
b. The headache lasts between 30 minutes to 7 days
c. At least two of the following typical picture of pain :
- Quality of pain as tied or pressed
- The pain intensity is  mild to moderate
- Bilateral
- Not aggravated by walking up the stairs or similar physical activity
d. No nausea or vomiting , no photophobia and phonophobia

Episodic Tension Type Headache is a frequent classified into 2, namely:
1) Episodic Tension Type Headache is a frequent associated with pericranial tenderness. It is characterized by increased tenderness perikranial, on manual palpation.
2) Tension Type Headache Episodic that frequent that is not associated with pericranial tenderness.


2 . Chronic tension-type headache
a. Average headache frequency > 15 days / month ( > 180 days / year ) for 6 months who meet the above criteria 1b - 1d
b. Have at least two typical picture of pain in episodic tension-type headache
c. There is no vomiting, and no more of the following : nausea, photophobia or phonophobia

Chronic Tension Type Headache (CTTH) are classified into 2 namely:
1) Chronic Tension Type Headache associated with pericranial tenderness. It is characterized by increased pericranial tenderness on manual palpation.
2) Tension Type Headache Chronic pain is not associated with pericranial pressure



Source
1. pict: http://chiropracticcareobx.com/headaches/tension-headache-treatments.html