Tension headache

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Tension headache , also known as tension headache , is the most common type of primary headache. The pain can radiate from the lower back of the head, neck, eyes, or other muscle groups in the body typically affecting both sides of the head. Tension headache type covers almost 90% of all headaches.

Pain medications, such as aspirin and ibuprofen, are effective for the treatment of tension headaches. Tricyclic antidepressants seem to be useful for prevention. Bad evidence for SSRIs, propranolol, and muscle relaxants.

In 2013, tension headaches affect about 1.6 billion people (20.8% of the population) and are more common in women than men (23% to 18%, respectively).

Video Tension headache

Signs and symptoms

Tension type headache pain is often described as constant pressure, as if the head is being squeezed in a vise. Pain often appears on both sides of the head at the same time. Tension type headache pain is usually mild to moderate, but can be severe.

According to the third edition of the International Classification of Headache Disorders, the attack must meet the following criteria:

• Duration between 30 minutes and 7 days.
• At least two of the following four characteristics:
  • bilateral location
  • press or tighten (not beat) quality
  • mild or moderate intensity
  • is not exacerbated by routine physical activity such as walking or climbing stairs
• The following two things:
  • no nausea or vomiting
  • no more than one photophobia (sensitivity to bright light) or phonophobia (sensitivity to loud noises)

Tension-type headaches may be accompanied by scalp tenderness at manual pressure during an attack.

Based on frequency, tension type headache can be classified as sub

• Episodic rarely: occurs less than once per month on average, or less than 12 episodes per year;
• Frequent episodes: occur between 1-14 times per month on average for at least 3 months;
• Chronic: occurs 15 times a month for at least 3 months (CTTH - chronic tension headache ).

Maps Tension headache

Cause

A variety of precipitating factors can cause tension-type headaches in susceptible individuals:

• Stress: usually occurs in the afternoon after long work hours stressing or after the exam
• Lack of sleep
• Uncomfortable position of stress and/or bad posture
• Unorganized feeding time (hunger)
• Eyestrain

Tension type headaches can be caused by muscle tension around the head and neck.

Another theory is that pain can be caused by a functioning pain filter located in the brainstem. His view is that the brain misinterprets information - eg from temporal muscles or other muscles - and interprets this signal as pain. One of the major neurotransmitters that may be involved is serotonin. The evidence for this theory comes from the fact that chronic tension-type headaches can be successfully treated with certain antidepressants such as nortriptyline. However, the analgesic effect of nortriptyline on chronic-type chronic headache is not solely due to inhibition of serotonin reuptake, and possibly other mechanisms involved. Recent research on nitric oxide (NO) shows that NO mechanisms can play a key role in the pathophysiology of CTTH. Pain line sensitization may be caused by or associated with activation of nitric oxide synthase (NOS) and NO generation. Patients with chronic tension headache experience increased sensitivity to muscle and skin pain, which is indicated by low mechanical, thermal and electrical thresholds. Hyperexcitability of the central nociceptive neurons (in the trigeminal spinal nucleus, thalamus, and cerebral cortex) is believed to be involved in the pathophysiology of chronic tension-type headaches. Recent evidence for increased sensitivity of pain or hyperalgesia in CTTH strongly suggests that the central nervous system pain process is abnormal in these primary headache disorders. In addition, dysfunction in the pain inhibition system may also play a role in the pathophysiology of chronic tension headache.

If other treatments do not work, the healthcare provider may use an MRI to confirm a more complicated diagnosis (eg, persistent new persistent daily headache).

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Prevention

Lifestyle

Drinking water and avoiding dehydration helps prevent tension headaches. Using stress management and relaxing often makes the headache smaller. Drinking alcohol can make headaches more likely or severe. Good posture can prevent headaches if there is neck pain. People who have a clenched jaw can develop headaches, and getting treatment from the dentist may prevent the headache. Biofeedback techniques can also help.

Drugs

People who have 15 or more headaches in a month can be treated with certain types of daily antidepressants that act to prevent persistent tension headaches. In those who are prone to experiencing tension, the first-line preventive treatment is amitriptyline, whereas mirtazapine and venlafaxine are second-line treatment options. Tricyclic antidepressants seem to be useful for prevention. Tricyclic antidepressants have been found to be more effective than SSRIs but have greater side effects. Bad evidence for the use of SSRIs, propranolol, and muscle relaxants for the prevention of tension headaches.

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Treatment

Treatment for tension headaches right now is drinking water and make sure there is no dehydration. If symptoms do not improve within an hour for someone who has already had water, then stress reduction can solve the problem.

Drugs

Over-the-counter medications, such as acetaminophen, aspirin, or ibuprofen, can be effective but tend to only help as a treatment for several times a week at most. Analgesic/sedative combinations are widely used (eg combination of analgesics/antihistamines such as Syndol, Mersyndol and Percogesic, analgesic/barbiturate combinations such as Fiorinal). Frequent use of analgesics, can cause excessive headaches.

Botulinum toxin does not seem to help.

Manual therapy

The current evidence for acupuncture is minimal. The 2016 systematic review shows better evidence among those who often experience tension headaches, but concludes that further trials comparing acupuncture with other treatment options are needed.

People with tension-type headaches often use spinal manipulation, soft-tissue therapy, and myofascial trigger point treatments. The study of effectiveness varies. A systematic review of 2006 found no evidence supporting manual therapy for tension headaches. The structured review of 2005 found only weak evidence for the effectiveness of chiropractic manipulation for tension headaches, and it may be more effective for tension headaches than migraines. A Cochrane 2004 review found that spinal manipulation may be effective for migraine and tension headaches, and that spinal manipulation and neck exercises may be effective for cervicogenic headaches. Two other systematic reviews published between 2000 and May 2005 found no conclusive evidence to support spinal manipulation. A systematic review of manual therapies in 2012 found that handwork can reduce the frequency and intensity of chronic tension headache.

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Epidemiology

In 2013, tension headaches affect about 1.6 billion people (20.8% of the population) and are more common in women than men (23% to 18%, respectively). Despite its benign nature, tension-type headaches, especially in its chronic form, can provide significant defects in patients as well as burden society at large.

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Prognosis

A tense headache that does not occur as a symptom of another condition may be painful, but not harmful. It is usually possible to receive assistance through care. A tense headache that occurs as a symptom of another condition is usually lost when the underlying condition is treated. Frequent use of pain medication in patients with tension-type headaches can lead to over-development of headache or rebound headaches.

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References

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External links

• American Council for Headache Education
• National Headache Foundation
• The World Headache Alliance

Source of the article : Wikipedia