BASH Guideline

TTH is characterised by mild-moderate and not severe, headache. It is bilateral and often described as pressing or tightening like a vice or tight band.

It typically lacks the specific features that characterise migraine such as nausea, light and noise sensitivity.

The headache is not aggravated by routine physical activity and this is a key criterion for diagnosis (Kong et al., 2018; Rasmussen et al., 1991; Rasmussen et al., 1992; Ulrich et al., 1996).

Duration of pain can be variable with a range from half an hour to several days. TTH on 15 or more days per month for at least 3 months is termed chronic TTH.

Disabling TTH is rare. Most patients diagnosed with disabling TTH have migraine, and respond to triptans (Cady et al., 1997; Lipton et al., 2002)