Tension headaches Flashcards
what is the definition of tension headaches?
‘Normal’, featureless headaches, mild to moderate pain
A. ≥ 10 attacks occurring <1 day/month (<12 days/year) and fulfilling B-D
B. Headache lasting from 30 minutes to 7 days
C. Headache has two of the following characteristics: Bilateral, Pressing/tightening (non pulsating) quality, Mild or moderate intensity
4. Not aggravated by routine physical activity (e.g. walking or climbing stairs)
D. Both of the following: No nausea or vomiting (anorexia may occur), No more than one of photophobia and phonophobia, Not attributed to another disorder
what is the epidemiology of tension headaches?
Most common type of headache
Peak age 20-39
what is the aetiology of tension headaches?
Muscle contraction is often considered the cause of pain in tension-type headaches, but there is little evidence to support this. In tension-type headaches, pericranial muscle contraction is either normal or slightly increased and the extent of muscle contraction does not correlate with the extent of head pain. Psychological stress is the most common trigger for tension-type headache. Extended periods of mental tension or psychological stress may play a role in central sensitisation and the development of chronic tension-type headache. Disturbed sleep patterns can trigger an episodic tension-type headache. Insomnia and other sleep disorders are associated with chronic tension-type headache
what are the risk factors of tension headaches?
Muscle contraction is often considered the cause of pain in tension-type headaches, but there is little evidence to support this. In tension-type headaches, pericranial muscle contraction is either normal or slightly increased and the extent of muscle contraction does not correlate with the extent of head pain. Psychological stress is the most common trigger for tension-type headache. Extended periods of mental tension or psychological stress may play a role in central sensitisation and the development of chronic tension-type headache. Disturbed sleep patterns can trigger an episodic tension-type headache. Insomnia and other sleep disorders are associated with chronic tension-type headache.
what is the pathophysiology of tension headaches?
As with migraine, the release and activation of inflammatory agents leads to sensitisation of peripheral trigeminal afferents and ultimately in central hypersensitivity. It has been speculated that in tension-type headache, the major nociceptor is the pericranial musculature, whereas in migraine, it is blood vessels and meningeal nociceptors. This concept helps explain why patients frequently report both migraine and tension-type headaches.
what are the key presentations of tension headaches?
Risk factors Generalised head pain Frontal or occipital pain Non-pulsating head pain Constricting pain Normal neurological examination
what are the signs of tension headaches?
Risk factors
Frontal or occipital pain
Normal neurological examination
what are the symptoms of tension headaches?
Generalised head pain
Non-pulsating head pain
Constricting pain
how are tension headaches diagnosed?
Clinical diagnosis
what are the differential diagnoses
Chronic migraine, medicine overuse, sphenoid sinusitis
how are tension headaches managed?
Acute attack:
Simple analgesics
Chronic:
Antidepressants, non-drug therapies, muscle relaxants
how are tension headaches monitored?
Follow-up is considered every few months for patients with tension-type headache to determine progress and for medicine adjustments.
what are the complications of tension headaches?
peptic ulcers
what is the prognosis of tension headaches?
Tension-type headaches are probably the most common type of headache in the general population. They are most common between the ages of 20 to 39 years and then decline. Self-treatment with simple analgesic medicine is usually effective.
