Chronic tensiontype headache 2 2 introduction tensiontype headache tth is the most common type of headache and has a high socioeconomic impact 1. Otherwise, they share the following characteristics. Use a heating pad set on low, a hot water bottle, a hot shower or bath, a warm compress, or a hot towel. The pathophysiology of tensiontype headache when making a diagnosis of tensiontype headache, the following factors are particularly important. Tension type headache tth is the most common and most socioeconomically costly headache. Over the past few decades research on headache has centred on migraine, and much of the best quality evidence for the treatment of tension type headache is decades old. A tensiontype headache is the most common type of headache and the one we think of as a normal everyday headache. Tensiontype headache is one of the most common primary headache disorders. An optimal reading and support relevant research in the area. The primary headache syndromes are migraine, tensiontype, and cluster headaches. Epidemiology of tensiontype headache headache jama. Attention to lifestyle factors, such as stress, posture and exercise, may help to prevent headaches. Tensiontype headache merck manuals professional edition.
Primary headaches account for more than 90% of all headache complaints, and of these, episodic tension type headache is the most common. Tensiontype headache, chronic tensiontype headache, and. Pathophysiology of migraine american headache society. The complete headache chart type symptoms precipitating factors treatment prevention hangover headaches migraine. Nov 21, 2017 tth is the most common type of chronic recurring head pain. The pain can radiate from the lower back of the head, the neck, eyes or other muscle groups in the body typically affecting both sides of the head. This book provides a detailed overview of the current state of knowledge regarding the pathophysiology of both primary headaches migraine, tensiontype headache tth, and cluster headache and the very important and frequent type of secondary headache, medication overuse headache moh. This discovery has important implications for the pathophysiology of migraine. If there are any features of migraine, diagnose chronic migraine. Pathophysiology of tensiontype headache, current pain and. Tension headache diagnosis and treatment mayo clinic.
The diagnosis is based on the history and examination. Tension headache is the most common primary headache and accounts for 90% of all headaches. As discussed at the outset, most of the patients of infrequent episodic tension type headache will not report to the physicians and usually take overthecounter analgesics. Eight and two were diagnosed with tension type and probable tension type headache, respectively. Migraine and cluster headaches are episodic and recurring conditions. Unfortunately, repeated use of overthecounter otc pain relievers can actually cause another type of headache, overuse headaches. Tensiontype headache definition tensiontype headache tth is the most common form of headache. The division of tensiontype headache into episodic and chronic types adopted by the. In the past, pain etiology was presumed to be the muscular contraction of painsensitive structures of the cranium, but the ihs intentionally abandoned the terms muscular contraction headache and tension headache because no research supports muscular contraction as the sole pain etiology. Increased tenderness to palpation of pericranial myofascial tissues is the most apparent abnormality in patients with tension type headache. Apply heat or ice to relieve tense neck and shoulder muscles. Acute treatment and tensiontype headache in adults.
The pathophysiology of tension type headache is still far from clear, although recent advances in basic and clinical research have increased our knowledge about mechanisms underlying this disorder. The neurophysiologic investigation of the pathophysiological mechanisms subtending migraine and tension type headache in children and adolescents could be particularly interesting, since during the developmental age the migrainous phenotype is scarcely influenced by many environmental factors that can typically act on adult headache patients. Tension headache, also known as tensiontype headache tth or stress headache, is the most common type of primary headache. Neuronal calciumchannels mediate serotonin 5ht release within the midbrain 2. A disorder evolving from frequent episodic tensiontype headache, with daily or very frequent episodes of headache, typically bilateral, pressing or tightening in quality and of mild to moderate intensity, lasting hours to days, or unremitting. Tensiontype headache typically causes pain that radiates in a bandlike. Tension headache, also known as tension type headache tth or stress headache, is the most common type of primary headache. Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue. The pain of a tensiontype headache is usually mild to moderate and often described as viselike. Regarding treatment for oromandibular dysfunction, since headachefree subjects. Upon withdrawal, some patients continue to remain headache free while. The chronic type cch is defined by attacks that occur daily for more than one year without remission or with remission periods lasting less than 14 days. Tension type headache is one of the most common primary headache disorders. Scribd is the worlds largest social reading and publishing site.
Tension headache is the most common form of headache. It may feel like a constant ache that affects both sides of the head. If an individual experiences tnsiontype headaches 14 or. Some people with tension headaches dont seek medical attention and try to treat the pain on their own. Headache online medical reference from definition and diagnosis through risk factors and treatments. May 10, 2019 tense muscles can trigger tension type headaches. Ice pick ice cream exertional cough chronic paroxysmal hemicrania sunctshortlasting unilateral neuralgiform head ache. Pdf tensiontype headache tth is the most common form of. Mar 14, 2018 tension headache is a primary headache which means that it is not caused by other conditions. The pain lasts for at least several hours to days and is predominantly felt bilaterally. At least 10 episodes fulfilling following criteria headache lasting 30 mins to 7 days has 2 at least 2 of the following bilateral location pressingtightening nonpulsating quality mild or moderate intensity not aggravated by physical activity such as walking or climbing stairs no nausea or vomiting free period between cluster headache bouts.
Pathophysiology, clinical features, and diagnosis, section on pathophysiology. Although societal impact is considerable, individual impact and disability is also substantial. Or apply an ice pack wrapped in a cloth or a cool washcloth across the forehead. Central sensitization in tensiontype headachepossible. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes. Increased excitability of the central nervous system generated by repetitive and sustained pericranial myofascial input may be. The most frequently observed headache was the chronic headache secondary to analgesic abuse 2251, followed by the migraine without aura 1551, tension type headache 351, migraine with aura 151, temporomandibular joint disorder 151 and hemiplegic migraine 151. While the pathophysiology of tth is still not entirely understood, it is now thought that it is a referred pain, stemming from the peripheral muscles. Cluster headache ch, also known as histamine headache, is a neurovascular headache disorder, where the pathophysiology and etiology are not well known. The pain does not worsen with routine physical activity, but may be. Yet our knowledge regarding tth pathophysiological mechanisms is still in its early stages. Pathophysiology of tension type headache work days each year approximating 820 per employees three times the number seen with migraine. Advances in basic pain and clinical research have improved our understanding of pathophysiologic mechanisms of tension type headache.
The neurophysiologic investigation of the pathophysiological mechanisms subtending migraine and tensiontype headache in children and adolescents could be particularly interesting, since during the developmental age the migrainous phenotype is scarcely influenced by many environmental factors that can typically act on adult headache patients. Although tensiontype headaches are common, the pathophysiology and likely. There was a negative correlation between the total sf36 and hit6 scores spearmans correlation. The aim of the present thesis was to investigate the pathophysiology of chronic tensiontype headache with special reference to central mechanisms. Tensiontype headache is divided into infrequent, frequent, and chronic subtypes, defined by the number of episodes suffered per month. Pathophysiology of tensiontype headache springerlink. May 28, 2005 pathophysiology of tension type headache ashina, sait. Pathophysiology of migraine and tensiontype headache. Recent progress in basic and clinical research has increased our understanding of pathophysiology of these headaches. Studies in tensiontype headache suggest that its pathogenesis is. Chronic tensiontype headache goteborgs universitet. Pathophysiology of cluster headaches, migraines and tension type headaches. Tensiontype headache is not as well studied as migraine and was once thought to be primarily psychogenic. Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers.
As many as 90% of adults have had tensiontype headache these headaches are typically a steady ache rather than a throbbing one, and affect both sides of the head distracting but usually not debilitating. Eight and two were diagnosed with tensiontype and probable tensiontype headache, respectively. As many as 90% of adults have had tension type headache these headaches are typically a steady ache rather than a throbbing one, and affect both sides of the head distracting but usually not debilitating. Excellent book containing updated research on tensiontype headache and cervicogenic, with optimal organization of the chapter by relevant topics, from the neurophysiological basis of all components that involve pain to the main research treatments for these types of headache. The words tension and type underscore its uncertain pathogenesis and indicate that some kind of mental or muscular tension may play. Tension type headache 05012002 migraine headache clinical evidence handbook. Medication to prevent headaches may help those who have frequent tensiontype headaches. The effect of autogenic relaxation on chronic tension headache and in modulating cortisol. Psychological stress and weak coping mechanisms may initiate and propagate physiological pain via activation of second messengers in downstream substrates involved in pain. Pathophysiology of headaches from molecule to man messoud. Jan 01, 2012 migraine and tension type headache are common in general population.
At least 10 episodes fulfilling following criteria headache lasting 30 mins to 7 days has 2 at least 2 of the following bilateral location pressingtightening nonpulsating quality mild or moderate intensity not aggravated by physical activity such as walking or climbing stairs no nausea or vomiting washington state health care authority health technology clinical committee andrea c. In context focal point migraine and headache harold george wol. Cortical spreading depression is probably the event underlying the aura of migraine, and biochemical and other studies suggest that a state of increased excitability of central neurons may lead to development and propagation of cortical spreading depression. Headaches in general are thought to affect more than 90% of the population at one time or another, with about. Tensiontype headache 05012002 migraine headache clinical evidence handbook.
The pathophysiology of tensiontype headache is still far from clear, although recent advances in basic and clinical research have increased our knowledge about mechanisms underlying this disorder. It is also one of the most neglected headache types and 2, in its chronic form, chronic tension type headache ctth is one of the most difficult types of headache to treat 1. It can be categorized into three subtypes according to the international classification of headache disorders based on headache frequency. New treatment modalities and drugs for the treatment of these headaches are emerging. Now in its third edition beta version, this system includes a tension type headache tth category, further defined as either episodic or chronic. Published estimates of the prevalence of tensiontype headache vary over a wide range from 1. Diagnosis of tensiontype headache, migraine and cluster. Experimental studies suggest that increased excitability of the cns generated by repetitive and sustained pericranial myofascial input may. Increased excitability of the central nervous system generated by repetitive and sustained pericranial myofascial input may be responsible for the transformation of episodic tension type. Tension type headache tth is the most prevalent primary headache disorder. Ch involves a gathering of headaches, typically over a period of several weeks with attacks of severe or very severe, strictly unilateral.
Method patients five hundred six patients consecutively referred to the unit of headachefacial pain, department of clinical pathophysiology, university of turin turin, italy and fulfilling the international headache society ihs diagnostic criteria 16 for episodic migraine em, episodic tensiontype headache etth, cm, and chronic. Peripheral pain mechanisms are most likely to play a role in 2. Nov 21, 2017 the international headache society ihs began developing a classification system for headaches in 1985. Tensiontype headache tth is the most common and most socioeconomically costly headache. So, if you have a tension type headache, a doctors examination will be normal apart from the muscles around the head perhaps being a little tender when a doctor presses on them. Fibromyalgia among patients with chronic migraine and chronic tension.
Tensiontype headaches account for nearly 90% of all headaches. Tensiontype headaches tth are the most common type benign headache. What is the proposed pathophysiology for tensiontype headache. Tensiontype headache is a highly prevalent condition that can be disabling. Headache pathophysiology imaging and neurophysiology, 2017. Tension type headaches tth are recurrent episodes of headache lasting minutes to weeks. Increased tenderness to palpation of pericranial myofascial tissues is the most apparent abnormality in patients with tensiontype headache. Headache is considered primary when a disease or other medical condition does not cause the headache. Advances in the pathophysiology of tensiontype headache. An important factor in the longterm prognosis of tth is the overuse of acute medications used to treat headache.
Tensiontype headache causes mild generalized pain usually viselike without the incapacity, nausea, or photophobia associated with migraine. There are many reasons why patients with tth overuse acute medications, including biobehavioral influences, dependency, and a lack of patient education. Advances in basic pain and clinical research have improved our understanding of pathophysiologic mechanisms of tensiontype headache. After tension headache, the second most frequently. For patients with frequent episodic tension type headache, simple analgesics and nsaidss are the mainstays in the acute therapy.
A wide variation in the prevalence of tensiontype headaches has been documented in. Chronic tension type headache 2 2 introduction tension type headache tth is the most common type of headache and has a high socioeconomic impact 1. Tension type headache tth is the most common headache and it has been discussed for years without reaching consensus on its pathophysiology, or proper rationale management. Painkillers, taken only when needed for the pain, work well in most cases. Increased pericranial tenderness is the most significant. Migraine is a neurovascular headache with complex pathophysiology, which has not been fully clarified.
Pathophysiology of cluster headaches, migraines and tensiontype headaches. It has been proposed that peripheral pain pathways most likely play a role in episodic tension type headache, whereas central pain pathways play a more important role in chronic tension type headache. Accompanying symptoms and psychiatric comorbidity in migraine. Tension type headache tth is the most common headache type and also the most difficult to classify. Pathophysiology of headacheprimary headachessecondary. The aim of the present thesis was to investigate the pathophysiology of chronic tension type headache with special reference to central mechanisms.
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