Published estimates of the prevalence of tensiontype headache vary over a wide range from 1. 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. There was a negative correlation between the total sf36 and hit6 scores spearmans correlation. The complete headache chart type symptoms precipitating factors treatment prevention hangover headaches migraine. Increased pericranial tenderness is the most significant. Tension type headache tth is the most common and most socioeconomically costly headache. Nov 21, 2017 the international headache society ihs began developing a classification system for headaches in 1985. The pathophysiology of tensiontype headache when making a diagnosis of tensiontype headache, the following factors are particularly important.
Fibromyalgia among patients with chronic migraine and chronic tension. Studies in tensiontype headache suggest that its pathogenesis is. Tension headache, also known as tensiontype headache tth or stress headache, is the most common type of primary headache. Now in its third edition beta version, this system includes a tension type headache tth category, further defined as either episodic or chronic. 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. Tensiontype headache 05012002 migraine headache clinical evidence handbook. Pathophysiology of tension type headache work days each year approximating 820 per employees three times the number seen with migraine. Eight and two were diagnosed with tension type and probable tension type headache, respectively. There are many reasons why patients with tth overuse acute medications, including biobehavioral influences, dependency, and a lack of patient education. For patients with frequent episodic tension type headache, simple analgesics and nsaidss are the mainstays in the acute therapy. The pain lasts for at least several hours to days and is predominantly felt bilaterally.
Tension type headache 05012002 migraine headache clinical evidence handbook. The pain does not worsen with routine physical activity, but may be. In context focal point migraine and headache harold george wol. The words tension and type underscore its uncertain pathogenesis and indicate that some kind of mental or muscular tension may play. 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. Advances in basic pain and clinical research have improved our understanding of pathophysiologic mechanisms of tensiontype headache.
Pathophysiology of tensiontype headache springerlink. Painkillers, taken only when needed for the pain, work well in most cases. Although societal impact is considerable, individual impact and disability is also substantial. Tensiontype headache is divided into infrequent, frequent, and chronic subtypes, defined by the number of episodes suffered per month. Or apply an ice pack wrapped in a cloth or a cool washcloth across the forehead. Pathophysiology of cluster headaches, migraines and tension type 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.
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. Pathophysiology of migraine american headache society. Some people with tension headaches dont seek medical attention and try to treat the pain on their own. Medication to prevent headaches may help those who have frequent tensiontype headaches. Recent progress in basic and clinical research has increased our understanding of pathophysiology of these headaches. Acute treatment and tensiontype headache in adults. New treatment modalities and drugs for the treatment of these headaches are emerging. Central sensitization in tensiontype headachepossible. 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. Tensiontype headache, chronic tensiontype headache, and.
Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue. What is the proposed pathophysiology for tensiontype headache. Neuronal calciumchannels mediate serotonin 5ht release within the midbrain 2. Chronic tensiontype headache goteborgs universitet. The primary headache syndromes are migraine, tensiontype, and cluster headaches. Attention to lifestyle factors, such as stress, posture and exercise, may help to prevent headaches. After tension headache, the second most frequently. Headache pathophysiology imaging and neurophysiology, 2017.
The division of tensiontype headache into episodic and chronic types adopted by the. Eight and two were diagnosed with tensiontype and probable tensiontype headache, respectively. Headache online medical reference from definition and diagnosis through risk factors and treatments. Scribd is the worlds largest social reading and publishing site. Pathophysiology of tensiontype headache, current pain and. Use a heating pad set on low, a hot water bottle, a hot shower or bath, a warm compress, or a hot towel. An optimal reading and support relevant research in the area. The aim of the present thesis was to investigate the pathophysiology of chronic tensiontype headache with special reference to central mechanisms. Pathophysiology of migraine and tensiontype headache. Advances in basic pain and clinical research have improved our understanding of pathophysiologic mechanisms of tension type headache.
Tensiontype headache is one of the most common primary headache disorders. It may feel like a constant ache that affects both sides of the head. You may also feel the neck muscles tighten and a feeling of pressure behind the eyes. Jan 01, 2012 migraine and tension type headache are common in general population. Regarding treatment for oromandibular dysfunction, since headachefree subjects. 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. If there are any features of migraine, diagnose chronic migraine.
Tension headache is the most common form of headache. Otherwise, they share the following characteristics. 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. Diagnosis of tensiontype headache, migraine and cluster. Pathophysiology of headaches from molecule to man messoud.
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. Tension headache is the most common primary headache and accounts for 90% of all headaches. Nov 21, 2017 tth is the most common type of chronic recurring head pain. Yet our knowledge regarding tth pathophysiological mechanisms is still in its early stages. Advances in the pathophysiology of tensiontype headache. Peripheral pain mechanisms are most likely to play a role in 2.
The diagnosis is based on the history and examination. 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. 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. Ch involves a gathering of headaches, typically over a period of several weeks with attacks of severe or very severe, strictly unilateral. Tension type headache tth is the most prevalent primary headache disorder. Although tensiontype headaches are common, the pathophysiology and likely. The pain of a tensiontype headache is usually mild to moderate and often described as viselike. Headaches in general are thought to affect more than 90% of the population at one time or another, with about. 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. Accompanying symptoms and psychiatric comorbidity in migraine.
Chronic tensiontype headache 2 2 introduction tensiontype headache tth is the most common type of headache and has a high socioeconomic impact 1. Tensiontype headache merck manuals professional edition. Migraine and cluster headaches are episodic and recurring conditions. Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. Tension type headache tth is the most common headache type and also the most difficult to classify. 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. Mar 14, 2018 tension headache is a primary headache which means that it is not caused by other conditions. Tensiontype headache tth is the most common and most socioeconomically costly headache. This discovery has important implications for the pathophysiology of migraine.
Tensiontype headaches account for nearly 90% of all headaches. Tensiontype headache is not as well studied as migraine and was once thought to be primarily psychogenic. 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. Tensiontype headache causes mild generalized pain usually viselike without the incapacity, nausea, or photophobia associated with migraine.
Ice pick ice cream exertional cough chronic paroxysmal hemicrania sunctshortlasting unilateral neuralgiform head ache. Tension type headache is one of the most common primary headache disorders. Tensiontype headache is a highly prevalent condition that can be disabling. May 28, 2005 pathophysiology of tension type headache ashina, sait.
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. Tensiontype headaches tth are the most common type benign headache. Cluster headache ch, also known as histamine headache, is a neurovascular headache disorder, where the pathophysiology and etiology are not well known. Increased tenderness to palpation of pericranial myofascial tissues is the most apparent abnormality in patients with tensiontype 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. If an individual experiences tnsiontype headaches 14 or. Increased tenderness to palpation of pericranial myofascial tissues is the most apparent abnormality in patients with tension type headache. 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. Primary headaches account for more than 90% of all headache complaints, and of these, episodic tension type headache is the most common. The effect of autogenic relaxation on chronic tension headache and in modulating cortisol. It can be categorized into three subtypes according to the international classification of headache disorders based on headache frequency. Upon withdrawal, some patients continue to remain headache free while.
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. 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. Psychological stress and weak coping mechanisms may initiate and propagate physiological pain via activation of second messengers in downstream substrates involved in pain. A wide variation in the prevalence of tensiontype headaches has been documented in. Unfortunately, repeated use of overthecounter otc pain relievers can actually cause another type of headache, overuse headaches. Headache is considered primary when a disease or other medical condition does not cause the headache. Pathophysiology of headacheprimary headachessecondary. 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. A tensiontype headache is the most common type of headache and the one we think of as a normal everyday headache. 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. 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. Apply heat or ice to relieve tense neck and shoulder muscles.
Epidemiology of tensiontype headache headache jama. 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. Pathophysiology of cluster headaches, migraines and tensiontype headaches. May 10, 2019 tense muscles can trigger tension type headaches. 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. 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. An important factor in the longterm prognosis of tth is the overuse of acute medications used to treat headache. Tension headache, also known as tension type headache tth or stress headache, is the most common type of primary headache.
Tension headache diagnosis and treatment mayo clinic. Pdf tensiontype headache tth is the most common form of. Tensiontype headache typically causes pain that radiates in a bandlike. The aim of the present thesis was to investigate the pathophysiology of chronic tension type headache with special reference to central mechanisms. Tension type headaches tth are recurrent episodes of headache lasting minutes to weeks. Pathophysiology, clinical features, and diagnosis, section on pathophysiology.
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. Tensiontype headache definition tensiontype headache tth is the most common form of headache. Migraine is a neurovascular headache with complex pathophysiology, which has not been fully clarified. 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.
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