They can range from the occasional mild headache to daily disabling headaches in some cases. Use of pain relievers more than twice weekly places. Often, patients will live with headache pain for months or even years before seeking care. The effectiveness of caffeine as an adjuvant to ibuprofen has been documented in investigations of acute pain. Patients meeting one of the sets of criteria below may also meet the criteria for 1. The treatment of tension type headaches can be divided into two broad. Tensiontype headache merck manuals professional edition. Treatment of tension type headache typically involves the use of overthecounter analgesics. Find out what causes them and how they can be treated. Some people with tension headaches dont seek medical attention and try to treat the pain on their own. Tensiontype headache tth american migraine foundation. History and exam help to differentiate primary and secondary headaches. Central pain mechanisms play more important role in chronic tensiontype headache.
Ibuprofen plus caffeine in the treatment of tension. Text in blue in this algorithm indicates a linked corresponding annotation. Tensiontype headache algorithm diagnosis and treatment of headache eleventh editionjanuary 20 the patient would enter this algorithm from box 17 of the diagnosis algorithm. Acupuncture in primary headache treatment springerlink. Tension type headaches tth are recurrent episodes of headache lasting minutes to. The major cause is due to primary headache disorders such as migraines and tensiontype headaches.
Tension headache migraine headache, including menstrual migraine medication overuse headache also known as rebound headache. Treatment of tensiontype headache typically involves the use of overthecounter analgesics. Acupuncture has a long tradition of use for the treatment of many pain conditions, including headache. The common headache found is tension type headache tth. The appropriate headache diagnosis must be made before a treatment can be selected. Pathophysiology peripheral pain mechanisms are most likely to play a role in infrequent episodic tension type headache and frequent episodic tensiontype headache.
Tension headache, also known as tensiontype headache tth or stress headache, is the most common type of primary headache. Diagnosis of tensiontype headache is based on characteristic symptoms and a normal physical examination, which includes a. Tensiontype headache definition tensiontype headache tth is the most common form of headache. The pathogenesis of tth is multifactorial and varies between forms and individuals. Tensiontype headache tth is the most common form of headache, and chronic tensiontype headache ctth is one of the most neglected and difficult types of headache to treat.
If you have a new severe headache, or if your usual headache changes and is more severe. Central sensitization in tensiontype headachepossible pathophysiological mechanisms. Increased pericranial tenderness may be recorded by manual palpation. Pdf treatment of tensiontype headache researchgate. Tensiontype headaches often occur every day or nearly every day in individuals who seek treatment, but headaches must occur 15 or more days per month for at least 6 months to meet international headache society diagnostic criteria for chronic rather than episodic tensiontype headache. This material may not otherwise be downloaded, copied, printed, stored. 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. The only nonpharmacological treatment recommended in national institute and health care excellence nice guidelines is a course of acupuncture for tensiontype headache. Tension type headaches have been called by various names over the years, including tension headache, muscle contraction headache.
This guideline includes diagnosis and treatment of the most common headache types that are managed in primary care. Its effectiveness has been studied mainly for primary headaches, particularly for migraine and tensiontype headache tth. Use of pain relievers more than twice weekly places patients at risk. The diagnosis is based on the history and examination. Tensiontype headache tth is a common primary headache with tremendous socioeconomic impact. Role of acupuncture in the treatment or prevention of. Tension headache is the most common type of headache, which presents as a constant ache on both sides of the head.
Tender points are areas where manual pressure induces local pain, and trigger. Tension headache diagnosis and treatment mayo clinic. Preventative drug treatments for tensiontype headaches. Tensiontype headache tth is the most prevalent headache type and causes a high degree of disability. If your headaches are not wellcontrolled by your current treatments. Chronic tension headaches come and go over a prolonged period of time. Unfortunately, repeated use of overthecounter otc pain relievers can actually cause another type of headache, overuse headaches. The classification, clinical features, differential diagnosis and treatment of tension type headache are discussed in this paper.
We conducted a comprehensive literature search for srsmas in major databases from the. Limited knowledge of the underlying pathophysiology of tensiontype headache is not yet available, and there is no specific treatment. From a purely comparative effectiveness perspective, however, the evidence from clinical trials and meta. Scribd is the worlds largest social reading and publishing site. Tension type headaches are classified by the international headache society as chronic tension type headaches when they occur for 15 daysmonth or more and episodic tension type headaches when less than 15 daysmonth. Despite these apparently straightforward criteria, and that th is the most frequent headache type in the general population 6, it remains the least characteristic. Tension type headache tth is the most ubiquitous headache in the general population, and is one of the most common reasons why overthecounter analgesics are purchased. Tension type headaches are the most common form of headache, occurring in about threequarters of the general population. Peripheral mechanisms myofascial nociception and central mechanisms sensitisation and inadequate endogenous pain control are.
Tensiontype headache patient meets criteria for tensiontype headache. For many headache sufferers, these headaches impair their daily activities. Tensiontype headache tth is the most prevalent headache type and causes a high degree of. Our objectives were to assess this agent in the treatment of tension. Tensiontype headache is the most common of the primary headache disorders, yet it is overshadowed by the less. Treatment of tensiontype headache typically involves the use of. Headache remains the most common cause of neurological consultation in clinical practice for which correct diagnosis and treatment are essential. They used to be commonly referred to as muscle contraction. It can be categorized into three subtypes according to the international classification of headache disorders based on headache frequency. Guidelines for trials of drug treatments in tensiontype. Very rarely are headaches a sign of a serious medical issue. These headaches can be mild and episodic, but they can also be chronic and disabling.
Despite the high frequency of tth and the total disability society bears due to this primary headache, treatment has been driven more by anecdote and wordofmouth consensus. Tensiontypelike headache missing one of the features required to fulfil all criteria for a type or subtype of tensiontype headache coded above, and not fulfilling criteria for another headache disorder. Tensiontype headache typically causes pain that radiates in a. In this paper, the clinical presentation of tensiontype headache is described, and treatment strategies for the acute episode as well as for the prophylaxis of chronic tensiontype headache are summarized. Tensiontype headaches are the most common type of headaches among adults. Tensiontype headache is probably the most frequent presenting complaint to the majority of practicing neurologists, and drs olesen and schoenen are correct in drawing our attention to the startling fact that this volume is the first scientifically based book that focuses exclusively on. Few evidence based guidelines exist for the acute and preventive treatment. Guidelines for trials of drug treatments in tensiontype headache 5 found in the ihs classification 1.
Management of chronic tensiontype headache with tricyclic. Acupuncture for the treatment of tensiontype headache. About 50% of patients had a headache every day of their lives that may persist for 1030 years or more. Often, patients will live with headache pain for months or even years.
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