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Current Pain and Headache Reports Dec 2006Tension-type headache is the most prevalent type of primary headache but is frequently forgotten by the patient and doctor. This article summarizes the present knowledge... (Review)
Review
Tension-type headache is the most prevalent type of primary headache but is frequently forgotten by the patient and doctor. This article summarizes the present knowledge about tension-type headache and discusses some of the problematic aspects. Most patients in specialized headache clinics suffer from several different primary and secondary headaches at the same time and deserve a careful characterization before a rational therapy can be initiated. In particular, it is of utmost importance to increase focus on clinical and basic research in order to develop effective treatment strategies for the most neglected and most costly type of headache.
Topics: Diagnosis, Differential; Humans; Tension-Type Headache
PubMed: 17087871
DOI: 10.1007/s11916-006-0077-0 -
Nihon Rinsho. Japanese Journal of... Oct 2005Tension-type headache is the most common type of primary headache. Life time prevalence of tension-type headache in general population ranges from 30 to 78%. It is the... (Review)
Review
Tension-type headache is the most common type of primary headache. Life time prevalence of tension-type headache in general population ranges from 30 to 78%. It is the least studied of the primary headache disorders, despite the fact that it has the highest socio-economic impact. In the new 'The International Classification of Headache Disorders', tension-type headache is divided into episodic and chronic subtypes. The exact mechanisms of tension -type headache are not known. Peripheral pain mechanisms are most likely to play a role in episodic headache, whereas central pain mechanisms play a more important role in chronic tension-type headache. Treatments of tension-type headache include not only medication but also the physical therapy. In many uncertain cases there is overuse of medication. Two months after medication overuse has ceased, chronic tension-type should be diagnosed.
Topics: Humans; Tension-Type Headache
PubMed: 16218384
DOI: No ID Found -
Current Opinion in Neurology Jun 2006Tension-type headache is the most common type of headache and, in its chronic form, one of the most neglected and difficult types of headache to treat. Recently... (Review)
Review
PURPOSE OF REVIEW
Tension-type headache is the most common type of headache and, in its chronic form, one of the most neglected and difficult types of headache to treat. Recently published data will be reviewed.
RECENT FINDINGS
The prevalence of frequent tension-type headache increased significantly from 1989 to 2001, and several risk factors have been identified. The incidence decreases markedly with age. The prognosis is fairly favorable for the episodic forms. Chronic tension-type headache, coexisting migraine, sleep problems and not being married were identified as risk factors for a poor outcome. Previous reports of sensitization of the central nervous system in patients with chronic tension-type headache were confirmed by the findings of generalized pain hypersensitivity both in skin and in muscles, and of a decrease in the volume of gray matter in brain structures. A promising new animal model of tension-type headache has been developed. In addition, the efficacy of a prophylactic drug, mirtazapine, with fewer side-effects than the tricyclic antidepressants has been demonstrated.
SUMMARY
The new data on the prevalence, incidence and prognosis of tension-type headache are valuable for health care planning and in daily clinical practice. The increased knowledge with regard to abnormal central pain modulation, together with the development of an animal model, hold promise for much-needed improvements in the understanding of pathophysiological mechanisms and treatment.
Topics: Humans; Prognosis; Risk Factors; Tension-Type Headache; Treatment Outcome
PubMed: 16702840
DOI: 10.1097/01.wco.0000227043.00824.a9 -
Current Pain and Headache Reports Dec 2004Although tension-type headache is at least as prevalent as migraine in children and adolescents, in contrast to migraine, childhood tension-type headache has received... (Review)
Review
Although tension-type headache is at least as prevalent as migraine in children and adolescents, in contrast to migraine, childhood tension-type headache has received limited research attention. Follow-up studies have shown that migraine may reverse in tension-type headache and vice versa. In addition, children with frequent episodic tension-type headache may be at increased risk of chronic tension-type headache. It is very important to recognize these children and to intervene. Further studies are needed to clarify the pathophysiology of pediatric tension-type headache.
Topics: Adolescent; Animals; Child; Humans; Migraine Disorders; Tension-Type Headache
PubMed: 15509465
DOI: 10.1007/s11916-004-0073-1 -
Neurology India 2022Tension type headache is one of the costliest primary headaches which can cause a significant impact on an individual's life. Healthcare professionals are exposed to...
BACKGROUND AND OBJECTIVES
Tension type headache is one of the costliest primary headaches which can cause a significant impact on an individual's life. Healthcare professionals are exposed to multiple trigger factors which give rise to an increase in headache frequency, most notable reasons being sleep disturbances, stress and untimely food habits. With this background, we conducted this study of detailed clinical profile and trigger factors among the 2050 subjects (MBBS students: 909, BDS students: 323, nursing students: 268, postgraduates students and staff: 550) in our medical institute.
MATERIALS AND METHODS
Subjects were given questionnaires on headache and were instructed to give the details of their clinical symptoms along with relevant questions on trigger factors. The assessment tools used were the Visual Analogue Scale (VAS) and Migraine Disability Assessment Scale (MIDAS).
RESULTS
Out of 2050 subjects, 464 patients suffered from tension type headache. Overall prevalence of tension type headache was 22.6%. Prevalence was higher in females (57.9%) as compared to males (42.1%). Headache experienced by majority of the student population was unilateral (31.4%), pulsating type (51.6%) and of moderate intensity (77.1%). Common associated symptoms were nausea associated with other factors (40%) and photophobia and phonophobia (18.6%). Stress (72.1%) and decreased sleep (49.4%) were the most common triggering factors. Practice of self-medication was reported by 80.2% of subjects.
CONCLUSION
Our study noted a high frequency of trigger factors in medical professionals, the most common triggering factors being stress and disturbed sleep. To our knowledge this is the first large study to evaluate headache and specifically tension type headache among medical professionals.
Topics: Male; Female; Humans; Tension-Type Headache; Headache; Migraine Disorders; Universities; Surveys and Questionnaires
PubMed: 36352594
DOI: 10.4103/0028-3886.359261 -
Cephalalgia : An International Journal... Jul 1999In this present thesis I have discussed the epidemiology and possible pathophysiological mechanisms of tension-type headache. A population-based study of 1000 subjects... (Review)
Review
In this present thesis I have discussed the epidemiology and possible pathophysiological mechanisms of tension-type headache. A population-based study of 1000 subjects randomly selected from a general population, two clinical studies, and a method study of EMG recordings, were conducted. Tension-type headache was the most prevalent form of headache, with a life-time prevalence of 78% in a general adult population. Thirty percent were affected more than 14 days per year and 3% were chronically affected, i.e. had headache at least every other day. Females were more frequently affected than males, and young subjects more frequently affected than older subjects. Females were more sensitive to mechanical pressure pain and revealed more tenderness from pericranial muscles and tendon insertions than males, and young subjects were more pain-sensitive than older subjects. Significantly higher tenderness in pericranial muscles was found in subjects with tension-type headache compared to migraineurs and to subjects without any experience of headache. Tenderness increased significantly with increasing frequency of tension-type headache in both males and females, whereas no such relation was found for mechanical pain thresholds. The applied EMG methodology was fairly reliable and nonpainful, but due to intersubject variability paired studies should be preferred. Subjects with chronic tension-type headache had slightly increased EMG levels during resting conditions and decreased levels during maximal voluntary contraction compared with headache-free subjects, indicating insufficient relaxation at rest and impaired recruitment at maximal activity. In a subsequent clinical, controlled study, the effect of 30 min of sustained tooth clenching was studied. Within 24 h, 69% of patients and 17% of controls developed a tension-type headache. Shortly after clenching, tenderness was increased in the group who subsequently developed headache, whereas tenderness was stable in the group of patients who remained headache-free, indicating that tenderness might be a causative factor of the headache. Likewise, psychophysical and EMG parameters were studied in 28 patients with tension-type headache, both during and outside of a spontaneous episode of tension-type headache. It was concluded that a peripheral mechanism of tension-type headache is most likely in the episodic subform, whereas a secondary, segmental central sensitization and/or an impaired supraspinal modulation of incoming stimuli seems to be involved in subjects with chronic tension-type headache. Prolonged nociceptive stimuli from myofascial tissue may be of importance for the conversion of episodic into chronic tension-type headache. The author emphasizes that tension-type headache is a multifactorial disorder with several concurrent pathophysiological mechanisms, and that extracranial myofascial nociception may constitute only one of them. The present thesis supplements the understanding of the balance between peripheral and central components in tension-type headache, and thereby, hopefully, leads us to a better prevention and treatment of the most prevalent type of headache.
Topics: Adult; Aged; Animals; Cross-Sectional Studies; Denmark; Disease Models, Animal; Electromyography; Facial Muscles; Female; Humans; Incidence; Male; Middle Aged; Migraine Disorders; Myofascial Pain Syndromes; Neck Muscles; Pain Threshold; Tension-Type Headache
PubMed: 10448549
DOI: 10.1046/j.1468-2982.1999.019006602.x -
Revue Medicale Suisse Mar 2020Tension-type headaches (TTH) are a very common condition. The most recent theories on TTH occurrences suggest that a myofascial component, through trigger points (TP),... (Review)
Review
Tension-type headaches (TTH) are a very common condition. The most recent theories on TTH occurrences suggest that a myofascial component, through trigger points (TP), gives rise to pain signals from the periphery to the central nervous system (CNS). These nociception could lead to CNS sensitization and headaches. Studies show that identification and treatment of TP is a valid therapeutic option for TTH. Amongst the treatment techniques, dry needling (DN) and ischemic compression (IC) seem to be the most effective. These technics can be easily acquired and applied by any doctor.
Topics: Humans; Pain; Pain Management; Tension-Type Headache; Trigger Points
PubMed: 32216185
DOI: No ID Found -
Current Pain and Headache Reports Dec 2007Migraine and tension-type headache (TTH) are highly prevalent primary headaches that remain underdiagnosed and undertreated in clinical practice. The similarities and... (Review)
Review
Migraine and tension-type headache (TTH) are highly prevalent primary headaches that remain underdiagnosed and undertreated in clinical practice. The similarities and differences between migraine and TTH may impose diagnostic challenges as well as management difficulties. In addition, the possibility of migraine chronification or transformation in daily or near-daily headache raises the potential level of interaction between pathophysiologic mechanisms of TTH and migraine. The continuum concept is a possible key to the understanding of this association. Future studies are necessary to clarify epidemiology, pathophysiology, and management of these two most prevalent headaches.
Topics: Chronic Disease; Disease Progression; Humans; Migraine Disorders; Tension-Type Headache
PubMed: 18173980
DOI: 10.1007/s11916-007-0232-2 -
Acta Neurologica Belgica Feb 2024Menstrual migraine (MM) is widely recognized among the scientific community, with diagnostic criteria included in the appendix of the third edition of the International... (Observational Study)
Observational Study
INTRODUCTION AND OBJECTIVE
Menstrual migraine (MM) is widely recognized among the scientific community, with diagnostic criteria included in the appendix of the third edition of the International Headache Classification. However, this classification does not include other primary headaches that may occur during menstruation. Previous retrospective studies suggest the existence of menstrual tension-type headache. Our objective is to prospectively determine the existence of this type of headache and to determine its frequency relative to that of MM.
METHODS
This is a descriptive, cross-sectional (case series), prospective, observational study, conducted in a hospital neurology department, using a previously validated ad hoc questionnaire. Participants were recruited by consecutive sampling, applying inclusion and exclusion criteria among women accompanying neurology outpatients, and classified into five groups: pure menstrual tension-type headache, menstrual-related tension-type headache, pure menstrual migraine, menstrual-related migraine and unclassifiable.
RESULTS
Ninety-five women (median age of 38.50 years, IQR: 13) were included, with the following group distribution: 13 (13.6%) pure menstrual tension-type headache, 14 (14.7%) menstruation-related tension-type headache, 23 (24.2%) pure menstrual migraine, 44 (46.3%) menstrual-related migraine and 1 unclassifiable. Of these patients, 23% did not treat menstrual headache, but this figure rose to 30.8% in the case of pure menstrual tension-type headache.
CONCLUSION
The results confirm the existence of pure menstrual tension-type headache among women who do not seek medical care for this condition. The frequency of this headache is lower than that of MM. This reduced incidence, together with its generally mild nature, may explain the lack of prior recognition.
Topics: Humans; Female; Adolescent; Tension-Type Headache; Menstruation; Cross-Sectional Studies; Prospective Studies; Headache; Migraine Disorders
PubMed: 37768535
DOI: 10.1007/s13760-023-02389-6 -
Neurological Sciences : Official... May 2014Tension-type headache (TTH) is the second most common human disease, accounting for intense disability, high costs and numerous workdays lost. Tension-type headache is... (Review)
Review
Tension-type headache (TTH) is the second most common human disease, accounting for intense disability, high costs and numerous workdays lost. Tension-type headache is less simple and easy-to-treat than commonly thought. Antidepressants, despite their poor tolerability, are still the first-choice drugs for preventing TTH. The most widely studied non-pharmacological approach to TTH, cognitive-behavioral techniques, effectively relieve pain only in selected patients. The most frequently used and recommended treatments for acute TTH, NSAIDs and paracetamol have scarce efficacy as documented by their low therapeutic gain over placebo in the 2-h pain-free response. Their effectiveness may be increased by a more proper use and by the adjunction of caffeine, antiemetics, myorelaxants or tranquillizers but the risk of medication-overuse headache must be considered. Hence, the need for more effective and tailored treatments in TTH remains.
Topics: Humans; Pain Management; Tension-Type Headache
PubMed: 24867829
DOI: 10.1007/s10072-014-1735-3