As with migraine, reassurance is important and often
effective on its own; it should never be omitted.
Underlying contributory factors are of greater potential
importance in TTH than in migraine. Effective treatment is
likely to depend on successfully identifying these, particularly
when headaches are frequent.
The distinction between episodic and chronic TTH, based
on frequency, is somewhat arbitrary but it has practical
importance for two reasons. One arises from the potential
for overuse of symptomatic medication, to the extent that
long-term harm outweighs short-term benefi t. Medication
overuse must always be discovered and remedied