Tension-Type Headache: Epidemiology, Diagnosis, and Pathophysiology

2016 ◽  
Author(s):  
Paul Rizzoli
Keyword(s):  
Large Body ◽  
Tension Type Headache ◽  
Central Pain ◽  
Pain Mechanisms ◽  
Epidemiologic Data ◽  
Prevalence Estimates ◽  
Socioeconomic Burden ◽  
Headache Epidemiology ◽  
Type Headache ◽  
Pathophysiologic Mechanisms

Tension-type headache (TTH) is a significant but underappreciated condition that is much more frequent than migraine, 42% versus 11%, and produces significant socioeconomic burden. Why then do research advances in this condition seem to lag? One reason is that precise epidemiologic data are lacking, with lifetime prevalence estimates varying from about 13 to 78%. Also, classification is confounded by whether or not to include the occasional but universal headache as TTH. Furthermore, TTH pathophysiology is debated, with some feeling that the pathophysiology of TTH is similar to and on a spectrum with migraine, and some feeling that it is entirely separate and related to peripheral and muscular mechanisms. More recently, central pain mechanisms have also been implicated in the pathophysiology. In addition, a large body of information connects stress and TTH. Although TTH varies widely in frequency and severity among and within patients, TTH pain, compared with pain in other headache types, could be characterized generally as more mild in severity and more generalized in location. This review discusses the current epidemiologic data and diagnostic challenges in TTH and the current pathophysiologic mechanisms.

Tension-Type Headache: Epidemiology, Diagnosis, and Pathophysiology

2016 ◽  
Author(s):  
Paul Rizzoli
Keyword(s):  
Large Body ◽  
Tension Type Headache ◽  
Central Pain ◽  
Pain Mechanisms ◽  
Epidemiologic Data ◽  
Prevalence Estimates ◽  
Socioeconomic Burden ◽  
Headache Epidemiology ◽  
Type Headache ◽  
Pathophysiologic Mechanisms

Tension-type headache (TTH) is a significant but underappreciated condition that is much more frequent than migraine, 42% versus 11%, and produces significant socioeconomic burden. Why then do research advances in this condition seem to lag? One reason is that precise epidemiologic data are lacking, with lifetime prevalence estimates varying from about 13 to 78%. Also, classification is confounded by whether or not to include the occasional but universal headache as TTH. Furthermore, TTH pathophysiology is debated, with some feeling that the pathophysiology of TTH is similar to and on a spectrum with migraine, and some feeling that it is entirely separate and related to peripheral and muscular mechanisms. More recently, central pain mechanisms have also been implicated in the pathophysiology. In addition, a large body of information connects stress and TTH. Although TTH varies widely in frequency and severity among and within patients, TTH pain, compared with pain in other headache types, could be characterized generally as more mild in severity and more generalized in location. This review discusses the current epidemiologic data and diagnostic challenges in TTH and the current pathophysiologic mechanisms.

Tension-Type Headache: Epidemiology, Diagnosis, and Pathophysiology

2017 ◽  
Author(s):  
Paul Rizzoli
Keyword(s):  
Large Body ◽  
Tension Type Headache ◽  
Central Pain ◽  
Pain Mechanisms ◽  
Epidemiologic Data ◽  
Prevalence Estimates ◽  
Socioeconomic Burden ◽  
Headache Epidemiology ◽  
Type Headache ◽  
Pathophysiologic Mechanisms

Tension-type headache (TTH) is a significant but underappreciated condition that is much more frequent than migraine, 42% versus 11%, and produces significant socioeconomic burden. Why then do research advances in this condition seem to lag? One reason is that precise epidemiologic data are lacking, with lifetime prevalence estimates varying from about 13 to 78%. Also, classification is confounded by whether or not to include the occasional but universal headache as TTH. Furthermore, TTH pathophysiology is debated, with some feeling that the pathophysiology of TTH is similar to and on a spectrum with migraine, and some feeling that it is entirely separate and related to peripheral and muscular mechanisms. More recently, central pain mechanisms have also been implicated in the pathophysiology. In addition, a large body of information connects stress and TTH. Although TTH varies widely in frequency and severity among and within patients, TTH pain, compared with pain in other headache types, could be characterized generally as more mild in severity and more generalized in location. This review discusses the current epidemiologic data and diagnostic challenges in TTH and the current pathophysiologic mechanisms.

scholarly journals CHRONIC TENSION-TYPE HEADACHE: MUSCLE OVERACTIVITY VERSUS DEFICIENT PAIN CONTROLS

2018 ◽  
Vol 11 (8) ◽  
pp. 143 ◽  
Author(s):  
Bhawna Mattoo ◽  
Suman Tanwar ◽  
Rohit Bhatia ◽  
Manjari Tripathi ◽  
Renu Bhatia
Keyword(s):  
Maximum Voluntary Contraction ◽  
Tension Type Headache ◽  
Pain Modulation ◽  
Electromyographic Activity ◽  
Healthy Controls ◽  
Pain Mechanisms ◽  
Chronic Tension Type Headache ◽  
Biceps Femoris Muscle ◽  
Type Headache ◽  
Central Factors

Objective: The oscillating school of thought between the peripheral and central mechanisms of pain origin hinders the selection of appropriate therapy for chronic tension-type headache (CTTH). The aim of this study was to assess the role of central and peripheral pain mechanisms together in CTTH.Methods: In the present study, we compared surface electromyography (sEMG) amplitudes and nociceptive flexion thresholds in patients diagnosed with CTTH (n=30) with age-matched healthy controls (n=30). For central pain modulation with spinal and supraspinal influences on nociception, we recorded nociceptive flexion reflex (NFR) by stimulating the sural nerve and observing the biceps femoris muscle response. sEMG was done for the temporalis and trapezius muscles at rest, during mental activity and during maximum voluntary contraction to assess contribution from peripheral pain.Results: We observed a decreased NFR threshold in CTTH patients as compared to healthy controls, suggesting a hyperalgesic state due to central factors. Electromyographic activity of trapezius muscle was increased at rest in CTTH while both temporalis and trapezius showed an overactivity in patients during mental task.Conclusion: Central factors are important in the pathogenesis of CTTH while, peripheral factors, such as stress-related muscle spasm may also contribute to pain state.

Stress and tension-type headache mechanisms

Cephalalgia ◽  
2010 ◽  
Vol 30 (10) ◽  
pp. 1250-1267 ◽  
Author(s):  
Stuart Cathcart ◽  
Anthony H Winefield ◽  
Kurt Lushington ◽  
Paul Rolan
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Tension Type Headache ◽  
Pain Processing ◽  
Central Pain ◽  
Comprehensive Review ◽  
Healthy Humans ◽  
The Central Nervous System ◽  
Type Headache ◽  
The Relationship

Stress is widely demonstrated as a contributing factor in tension-type headache (TTH). The mechanisms underlying this remain unclear at present. Recent research indicates the importance of central pain processes in tension-type headache (TTH) pathophysiology. Concurrently, research with animals and healthy humans has begun to elucidate the relationship between stress and pain processing in the central nervous system, including central pain processes putatively dysfunctional in TTH. Combined, these two fields of research present new insights and hypotheses into possible mechanisms by which stress may contribute to TTH. To date, however, there has been no comprehensive review of this literature. The present paper provides such a review, which may be valuable in facilitating a broader understanding of the central mechanisms by which stress may contribute to TTH.

Tension-type headache

2020 ◽  
pp. 259-266
Author(s):  
Stefan Evers
Keyword(s):  
Muscle Tension ◽  
Tension Type Headache ◽  
Central Pain ◽  
Pharmacological Management ◽  
Prophylactic Drugs ◽  
Pain Sensitization ◽  
Accompanying Symptoms ◽  
Type Headache ◽  
Antinociceptive Mechanisms

Tension-type headache (TTH) is usually a dull, bilateral headache without accompanying symptoms. It is divided into three subtypes: infrequent episodic TTH (< 1 headache day per month), frequent episodic TTH (1–14 headache days per month), and chronic TTH (≥ 15 headache days per month). This division is highly relevant for three reasons. Firstly, impact on quality of life differs considerably between the three subtypes. Secondly, the pathophysiological mechanisms also differ. Peripheral mechanisms such as muscle tension are more important in episodic TTH, whereas central pain sensitization with reduced antinociceptive mechanisms are pivotal in chronic TTH. Thirdly, treatment differs between the subtypes, with symptomatic and prophylactic treatment being more appropriate for episodic and chronic TTH, respectively. Non-pharmacological management should always be part of the treatment. Patients with episodic TTH are treated with analgesics, while prophylactic drugs (in particular antidepressants) should be considered in patients with very frequent episodic or chronic TTH.

Central pain processing in chronic tension-type headache

2009 ◽  
Vol 120 (7) ◽  
pp. 1364-1370 ◽  
Author(s):  
Kim Lindelof ◽  
Jens Ellrich ◽  
Rigmor Jensen ◽  
Lars Bendtsen
Keyword(s):  
Tension Type Headache ◽  
Pain Processing ◽  
Central Pain ◽  
Chronic Tension Type Headache ◽  
Type Headache ◽  
Central Pain Processing

scholarly journals Prevalence and Characteristics of Headache in Khoramabad, Iran

2012 ◽  
Vol 4;15 (4;8) ◽  
pp. 327-332 ◽  
Author(s):  
Parviz Bahrami
Keyword(s):  
Associated Factors ◽  
Age Groups ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Total Prevalence ◽  
Study Population ◽  
Higher Educational ◽  
Headache Epidemiology ◽  
Type Headache ◽  
The Impact

Background: Headache is a prevalent and disabling condition affecting people in all age groups worldwide, leading to low job performance and quality of life with a significant economic burden on societies. Objective: We evaluated headache prevalence and characteristics and some probable associated factors in patients referring to neurology specialist clinics. Study Design: Cross sectional study Setting: Clinics of Khoramabad and also those referring to the emergency department of Khoramabad University Hospital. Methods: One thousand patients with a chief concern of headache were assigned to the study. All patients filled out a structured questionnaire to gather demographic information and data on headache characteristics and associated factors, including past medical and psychiatric history, history of oral contraceptive pill (OCP) use, nonsteroidal anti-inflammatory drug (NSAID) overuse, and menstruation. Results: The total prevalence of primary headaches was 78.2%, with migraine (with and without aura) being the most prevalent type with a prevalence of 41.6% followed by tension type headache found in 31.6% of the study population. Primary headaches were significantly more common in women and younger age groups. Factors found associated with a significantly higher prevalence of primary headaches were lower economic level, higher educational level, occupation, OCP use and NSAIDs overuse. Secondary headaches, with a total prevalence of 20.1%, significantly increased in older age groups and higher economic levels and were significantly less prevalent in higher educational levels. Limitations: The study population is not quite representative of the general population of Iran. Conclusion:‍‍ Results highlight the impact of socioeconomic factors on headache epidemiology in a developing country and demonstrate that OCPs and NSAIDs overuse might have an effect on the distribution of primary headaches. Further multicenter studies are needed to evaluate headache epidemiology in the whole country. Key words: headache, prevalance, migraine, tension-type headache

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