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In this review, the authors extensively discuss the current understanding of the pathophysiology of tension-type headache.
The authors highlight important distinctions between the pathophysiology of chronic tension-type headache, which is disabling, and that of episodic tension-type headache, which is not. They give a concise, evidence-based review of rational acute and preventive treatments. Because the concept of muscle contraction as a cause of tension-type headache is still pervasive, treatments are often directed toward muscle relaxation. The authors provide evidence to refute this concept. They critically discuss nonpharmacologic treatments, noting that evidence supports use of biofeedback and relaxation therapy and provides limited su…