Prevalence of Trigger Factors and Associated Disorders in Tension-type Headache

Headache is most common pain suffered by many. Tension-type headache is the most common primary headache disorder. As per the Global Burden of Disease Study 2010, Tension-type headache is the second most common disorder worldwide with an estimated prevalence of 20.8%. Trigger factors have been widely studied in the context of migraine, but very few studies have investigated trigger factors in the context of Tension-type headache.

To study the prevalence of trigger factors and associated disorders in tension-type headache researchers conducted a study including a total of 400 patients above the age of 15 years fulfilling the International Classification of Headache Disorders (ICHD 3) criteria of frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH). Details regarding demographics, headache characteristics, triggers, and associated symptoms were obtained. Associated psychiatric disorders were also recorded.

So the results showed that out of 400 patients, 360 (90%) were found to have triggers. The mean headache intensity on visual analog scale (VAS) was 6.7. The most common trigger factor was emotional stress among both males and females. There was a statistically significant difference in the frequency of trigger factors between men and women for emotional stress, sunlight, sleep deprivation/insomnia, noise, weather change, studying, fried food, and hypersomnia. Psychiatric comorbidity was found in 29% of individuals, with sleep disorder being the most common.

Tension-type headache has been an underrated diagnosis despite being an extremely common disorder. The trigger factors are less studied and their interactions are lesser known. The diagnostic criteria as per International Classification of Headache Disorders 3 make tension-type headache a diagnosis of exclusion, rather than a positive diagnosis of inclusion.

Therefore, the trigger factors must be included in the diagnostic criteria and associated psychiatric disorders should be sought for and treated simultaneously for better management and quality of life.

Reference:

Jain D, Pandey G. A Study on Prevalence of Trigger Factors and Associated Disorders in Tension-type Headache. J Assoc Physicians India 2022;70(11):41–46.