Tension-type headache in patients with concomitant musculoskeletal disorders

2020 ◽  
pp. 72-79
Author(s):  
Yu. O. Novikov ◽  
I. E. Salakhov
Keyword(s):  
Cervical Spine ◽  
Drug Therapy ◽  
Drug Treatment ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Tension Type Headache ◽  
World Health ◽  
Standard Drug ◽  
Rehabilitation Treatment ◽  
Type Headache

Introduction. According to the defi nition of the World Health Organization (WHO), tension-type headache (TTH) is the most common type of primary headache. Rehabilitation of patients with chronic tension-type headache continues to be an important socio-medical problem. Its main goal is the most complete restoration of the functions of the musculoskeletal system of the neck, the correction of vascular and psychoemotional problems, and the patient′s return to his everyday life and work. As a rule, the main emphasis in the treatment of such patients is placed primarily on drug therapy. At the same time, practitioners are faced with a number of problems — the low effectiveness of the treatment, the nonpersistency of the results, allergic reactions, polypharmacy and others. All this suggests that there is a need for differentiated rehabilitation treatment of patients with tension-type headache with the use of various non-pharaceutical methods. The goal of research — to evaluate the clinical effi cacy of complex non-drug therapy in patients with tension-type headache.Materials and methods. The prospective controlled randomized study, which was conducted from October 2017 to March 2019 at the Department of Medical Rehabilitation of the Bashkir State Medical University, included 110 patients with TTH from the age of 20 to 45 years. All patients, depending on the treatment methodology used, were randomly divided into two groups of 55 people. Patients of the main group received complex rehabilitation treatment with the use of non-drug methods: osteopathic correction, acupuncture and exercise therapy. Patients in the control group received treatment in accordance with the standard of medical care for TTH (analgesics, non-steroidal antiinfl ammatory drugs, antidepressants, vasoactive and nootropic drugs). The study of the clinical effectiveness of the therapy included: an assessment of the severity of pain with the use of a visual analogue scale and a tensoalgimeter, a goniometric study with an assessment of the volume of active movements in the cervical spine, transcranial ultrasound dopplerography with an assessment of quantitative indicators in the system of the middle cerebral artery.Results. The use of complex non-drug therapy in patients with TTH compared with standard drug therapy leads to a signifi cantly more important decrease in the severity of pain, an increase in pain threshold, an increase in the volume of active movements in the cervical spine. The effect of non-drug treatment methods on blood fl ow in the system of the middle cerebral artery is comparable in its effectiveness with the use of pharmaceutical drugs.Conclusion. The proposed complex rehabilitation treatment of patients with TTH with the use of non-drug methods has shown clinical effi cacy which is comparable, and in a number of indicators, superior to the effectiveness of conventional medical treatment. All this determines the necessity of wider implementation of multidisciplinary non-drug treatment of patients with this pathology.

scholarly journals Endovascular intervention for cerebral watershed infarction due to severe stenosis of the middle cerebral artery is safe and effective: A Retrospective Study

2019 ◽  
Author(s):  
Huifang Xie ◽  
Zhenxing Yan ◽  
Siqin Liu ◽  
Xiongjun He ◽  
Liang Zhang ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Blood Lipid ◽  
Endovascular Intervention ◽  
Severe Stenosis ◽  
Standard Drug ◽  
Drinking History ◽  
Time Of Admission ◽  
Watershed Infarction

Abstract Introduction The aim of this study was to compare the clinical outcomes of standard drug therapy and endovascular intervention for cerebral watershed infarction (WSI) due to severe stenosis of the middle cerebral artery.Methods 86 patients with WSI due to severe stenosis of middle cerebral artery were included 46 endovascular intervention patients and 40 standard drug patients. Clinical data were collected at the time of admission, discharge, and the 90-day return to the hospital for review.Results At the time of admission, there were no significant differences in the baseline data of age, gender, blood pressure, blood glucose, blood lipid, NIHSS, MOCA, or lifestyle characteristics such as smoking and drinking history(P>0.05).At 90 days after discharge, there were statistically significant differences in NHISS score(3.20 ± 1.65and4.35 ± 2.63,P=0.028), mRS score(0.69 ± 0.81and1.20 ± 0.96,P=0.01) and MOCA score(21.24 ± 3.72and19.02 ± 3.48,P=0.006) between the two groups.Conclusion The endovascular intervention for WSI due to severe stenosis of the middle cerebral artery has similar periprocedural complications and better outcomes compared to standard drug therapy.

The rationale for the combined use of osteopathic methods of correction and reflexology in the complex treatment of patients with dorsopathy at the cervico-thoracic level

2020 ◽  
pp. 82-94 ◽  
Author(s):  
V. O. Belash ◽  
L. R. Urazgalieva ◽  
R. I. Fayzullina ◽  
L. G. Agasarov
Keyword(s):  
Drug Therapy ◽  
Drug Treatment ◽  
Pain Syndrome ◽  
Clinical Effectiveness ◽  
Complex Treatment ◽  
Standard Drug ◽  
Treatment Methods ◽  
Thoracic Level ◽  
Combined Use ◽  
Complex Therapy

Introduction. Degenerative-dystrophic changes in the spine are the most common chronic human diseases. Pronounced clinical manifestations of vertebrogenic diseases are observed during active labor activity and represent one of the most frequent causes of temporary disability. It is also known that any pain syndromes are accompanied by the development of psychovegetative disorders, which reduces the effectiveness of treatment. In recent years, there has been a reasonable increase in the interest of the medical community to the non-drug treatment methods. It is caused by the polypharmacotherapy side effects, an increased numbers of allergic reactions, problems with polypragmasia, and a low level of compliance. At the same time, the question of the possibility of various non-drug treatment methods combining is quite acute.The goal of research is to substantiate the clinical effectiveness of the combined application of osteopathic correction and reflexotherapy in the complex treatment of patients with dorsopathy at the cervical-thoracic level.Materials and methods. A prospective controlled randomized study was conducted on the basis of the medical clinics of LLC «Family Health» (Kazan) and ANO «Center for SEB assistance» (Kazan) from April 2018 to May 2019. The study involved 52 people with dorsopathy at the cervical-thoracic level, aged from 25 to 45 years. In accordance with the exclusion criteria, 7 people dropped out of the study. The remaining patients (45 people), depending on the used treatment method, were divided by a simple randomization method using a random number generator into three groups of 15 people. The first group (main group) received osteopathic correction and reflexotherapyon the background of standard drug therapy; the second and the third groups (control groups) received only osteopathic correction orreflexotherapy, respectively, on the background of standard drug therapy. The osteopathic examination was performed for all patients regardless of the group, before and after the course of therapy, with the formation of an osteopathic conclusion.Also there was the estimation of the degree of pain syndrome severity,the asthenia, and the degree of accumulated emotional and energy charge that does not get out in a person.Results. It was found in the course of the study that the inclusion of osteopathic correction and reflexotherapy in the complex therapy of patients with dorsopathy at the cervical-thoracic level is clinically more effective than the isolated use of these methods. Such complex therapy allows to achieve a more significant reduction in the severity of the pain syndrome by VAS (p<0,05), relief of internal emotional tension (p<0,05), and increase the effectiveness of correction of dominant somatic dysfunction. Based on the obtained data, it could be assumed that reflexotherapy potentiates the effects of osteopathic correction.Conclusion. Based on the study, it can be concluded that the combination of osteopathic correction and reflexotherapy in the treatment of patients with dorsopathy at the cervical-thoracic level increases the clinical effectiveness of the standard drug therapy. At the same time, it is worth noting the potentiating effect of the combined use of two non-medicinal methods. The question of combining of various non-drug treatment methods is quite acute today, so this study will be continued. 

scholarly journals Evidence Based Migraine Prophylactic Drug Therapy

1999 ◽  
Vol 26 (3) ◽  
pp. 27-32 ◽  
Author(s):  
W.J. Becker
Keyword(s):  
Clinical Trials ◽  
Drug Therapy ◽  
Scientific Evidence ◽  
Tension Type Headache ◽  
Beneficial Effects ◽  
Symptomatic Medication ◽  
Prophylactic Drugs ◽  
Prophylactic Drug ◽  
Patient Will ◽  
Type Headache

Prophylactic drug therapy is a major component of overall migraine management. However, because we do not know how currently used prophylactic drugs exert their beneficial effects in migraine, their use is based primarily on clinical trials. In general, prophylactic drugs are indicated when patients have three or more attacks a month and symptomatic medication use alone is not satisfactory. The choice of drug must be individualized, and is influenced by contraindications, potential side effects, the need to treat associated symptoms like tension-type headache and insomnia, and drug cost. Whether an individual patient will respond to a given drug cannot be predicted, but there are varying degrees of scientific evidence supporting the use of each prophylactic drug in migraine. This evidence is best for metoprolol, divalproex, amitriptyline, atenolol, flunarizine and naproxen. Based on placebo-controlled crossover studies, it would appear that at least some prophylactic drugs exert the greater part of their prophylactic effects very quickly, and that these also disappear very quickly once the drug is stopped. This may not apply to all prophylactic drugs and more research is needed. More well designed clinical trials are needed to guide our use of migraine prophylactic drugs. Although clinical experience is useful, placebo responses and variations in the migraine tendency over time can make interpretation of this experience difficult. Major advances will likely only occur once the pathogenesis of migraine and the mode of action of the prophylactic drugs is better understood.

scholarly journals Effects of Muscle Energy Technique in Patients with Tension Type Headache; A Randomized Control Clnicial Trial

2021 ◽  
Author(s):  
Rabia Sohail ◽  
Huma Riaz ◽  
Muhammad Akhtar ◽  
Asim Raza ◽  
Kinza Shabbir ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Tension Type Headache ◽  
Control Group ◽  
Muscle Energy Technique ◽  
Randomized Control ◽  
Muscle Energy ◽  
Type Headache ◽  
And Control ◽  
Experimental Group

Abstract Background: Tension type headache is claimed to be one of top ten disabling conditions in the world. The purpose of the study was to determine the effects of muscle energy technique on pain, range of motion at cervical spine and disability related to tension type headache. Methods: A randomized control trial was conducted on 48 participants of both genders whose age was 18 to 40 years with complain of tension type at Rehabilitation and Injury Management Department of Medcare International Hospital Gujranwala, from July to December 2019. Participants were randomly selected and allocated into two groups (experimental and control group). The experimental group received both muscle energy technique and myofascial release technique on trapezius and sternocleidomastoid of both sides. The intervention was applied for 6 weeks (3 sessions per week). Assessments were done at baseline, 4th week and 6th week. Numeric pain rating scale (NPRS), Headache disability inventory (HDI), headache impact test (HIT) and cervical range of motion with the help of Inclinometer were tools for assessment. Data analysis was done using SPSS (version 21). Results: The mean age of experimental group was 26.5±5.42 and control group was 27.7±5.70. The experimental group was shown significant improvement in terms of pain and flexion and side flexion range of motion with p-value ≤0.05. Conclusion: It is concluded that muscle energy technique is effective treatment for tension type headache; it is associated to decreased range of motion at cervical spine and disability related to TTH. Trial registration: IRCT20190121042445N2, Registered 07-02-2021.

scholarly journals Dichotomy of music in the approach of tension-type headache

2021 ◽  
pp. 12-15
Author(s):  
Laura Santos Oliveira ◽  
Natália de Fátima Gonçalves Amâncio
Keyword(s):  
Negative Impact ◽  
Public Health Problem ◽  
Final Analysis ◽  
Tension Type Headache ◽  
World Health ◽  
Real Effects ◽  
High Prevalence ◽  
Triggering Factor ◽  
Type Headache ◽  
Health Organization

IntroductionHeadache is one of the most frequent diseases of the nervous system. Headache is considered a public health problem, due to its high prevalence - since more than 90% of the population will present this clinical condition throughout their lives according to the World Health Organization (WHO) and for its negative impact on quality of life. In such a subtype of headache, music is seen as an antithesis either for its relief action or not, with findings in both extremes.ObjectiveThe objective of this paper is to identify the real effects of routine listening to music in patients with tension-type headache, based on reports in the current literature. The present study consists of an integrative literature review on the effects of routine listening to music in patients with tension-type headache.MethodologyAfter careful reading of the publications, six articles were not used due to the exclusion criteria. Thus, 14 articles were selected for the final analysis and construction of the bibliographic review on the topic.ResultsAfter the analysis, in 50% of the studies, the intensity of the headache increased with listening to music, and in 50% of the studies the intensity of the headache with listening to music decreased.ConclusionIt can be concluded that music is related in an ambivalent way to cases of headache arising from several etiologies. When administered at high frequencies, it can be a triggering factor, presenting a higher incidence in those who listen to it in this way, if compared to those who listen to it in a less intense way. But when used systematically, with frequency and delimited periods - such as the music therapy mechanism - music reveals itself as a beneficial element to reduce the frequency and intensity of headache caused by different diseases.

scholarly journals Influence of complex physical rehabilitation on the dynamics of recovery of cognitive functions in patients who have been cerebral ischemic stroke

2021 ◽  
pp. 32-36
Author(s):  
Valeriia Mishchenko
Keyword(s):  
Ischemic Stroke ◽  
Drug Therapy ◽  
Cognitive Functions ◽  
Secondary Prophylaxis ◽  
Main Group ◽  
Physical Rehabilitation ◽  
Standard Drug ◽  
Rehabilitation Treatment ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic

The article presents the results of a study of the effect of a complex physical rehabilitation on the dynamics of restoration of cognitive impairments in patients in the early recovery period of the cerebral ischemic stroke. The study included 83 patients. All patients under study were distributed to the main group and the comparison group. The average age of the patients was 66,0 ± 2,3 years. Patients of two groups received standard drug therapy aimed at secondary prophylaxis. The patients under study from the main group additionally undertook a course of physical rehabilitation treatment within 21 days. Assessment of the condition of cognitive functions was carried out with the help of psychodiagnostic scales before the onset and after completion of treatment. The study showed that the use of a complex rehabilitation treatment, which includes drug therapy within the framework of secondary prophylaxis and course of physical rehabilitation can significantly affect the improvement of the state of moderately impaired cognitive functions in patients with a hemispheric ischemic stroke.

The Global Burden of Headache: A Documentation of Headache Prevalence and Disability Worldwide

Cephalalgia ◽  
2007 ◽  
Vol 27 (3) ◽  
pp. 193-210 ◽  
Author(s):  
LJ Stovner ◽  
K Hagen ◽  
R Jensen ◽  
Z Katsarava ◽  
RB Lipton ◽  
...  
Keyword(s):  
Chronic Daily Headache ◽  
International Headache Society ◽  
Adult Population ◽  
Tension Type Headache ◽  
World Health ◽  
Headache Disorders ◽  
Burden Of Headache ◽  
The World ◽  
Daily Headache ◽  
Type Headache

This study, which is a part of the initiative 'Lifting The Burden: The Global Campaign to Reduce the Burden of Headache Worldwide', assesses and presents all existing evidence of the world prevalence and burden of headache disorders. Population-based studies applying International Headache Society criteria for migraine and tension-type headache, and also studies on headache in general and 'chronic daily headache', have been included. Globally, the percentages of the adult population with an active headache disorder are 46% for headache in general, 11% for migraine, 42% for tension-type headache and 3% for chronic daily headache. Our calculations indicate that the disability attributable to tension-type headache is larger worldwide than that due to migraine. On the World Health Organization's ranking of causes of disability, this would bring headache disorders into the 10 most disabling conditions for the two genders, and into the five most disabling for women.

Roentgenographic Findings of the Cervical Spine in Tension-Type Headache

1993 ◽  
Vol 33 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Arata Nagasawa ◽  
Toshimasa Sakakibara ◽  
Akira Takahashi
Keyword(s):  
Cervical Spine ◽  
Tension Type Headache ◽  
Type Headache

Headache and the Cervical Spine: A Critical Review

Cephalalgia ◽  
1997 ◽  
Vol 17 (8) ◽  
pp. 801-816 ◽  
Author(s):  
W Pöllmann ◽  
M Keidel ◽  
V Pfaffenrath
Keyword(s):  
Cervical Spine ◽  
Critical Review ◽  
Primary Headache ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Differential Diagnoses ◽  
Primary Headaches ◽  
Unilateral Headache ◽  
Greater Occipital Nerve ◽  
Type Headache

Headache related to the cervical spine is often misdiagnosed and treated inadequately because of confusing and varying terminology. Primary headaches such as tension-type headache and migraine are incorrectly categorized as “cervicogenic” merely because of their occipital localization. Cervicogenic headache as described by Sjaastad presents as a unilateral headache of fluctuating intensity increased by movement of the head and typically radiates from occipital to frontal regions. Definition, pathophysiology, differential diagnoses and therapy of cervicogenic headache are demonstrated. Ipsilateral blockades of the C2 root and/or greater occipital nerve allow a differentiation between cervicogenic headache and primary headache syndromes such as migraine or tension-type headache. Neither pharmacological nor surgical or chiropractic procedures lead to a significant improvement or remission of cervicogenic headache. Pains of various anatomical regions possibly join into a common anatomical pathway, then present as cervicogenic headache, which should therefore be understood as a homogeneous but also unspecific pattern of reaction.

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