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In [[medicine]], '''tension headache''', also called '''tension-type headache''', '''stress headache''' or '''idiopathic headache''', is a "common primary [[headache]] disorder, characterized by a dull, non-pulsatile, diffuse, band-like (or vice-like) pain of mild to moderate intensity in the [[head]]; [[scalp]]; or [[neck]]. the subtypes are classified by frequency and severity of symptoms. there is no clear cause even though it has been associated with [[muscle contraction]] and stress.<ref>{{MeSH}}</ref><ref> International Headache Society . [http://ihs-classification.org/en/02_klassifikation/02_teil1/02.00.00_tension.html Tension-type-like headache]</ref>
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In [[medicine]], '''tension headache''', also called '''tension-type headache''', '''stress headache''' or '''idiopathic headache''', is a "common primary [[headache]] disorder, characterized by a dull, non-pulsatile, diffuse, band-like (or vice-like) pain of mild to moderate intensity in the [[head]]; [[scalp]]; or [[neck]]. the subtypes are classified by frequency and severity of symptoms. there is no clear cause even though it has been associated with [[muscle contraction]] and stress.<ref>{{MeSH}}</ref><ref name="IHS-II. Tension-type headache">International Headache Society. [http://ihs-classification.org/en/02_klassifikation/02_teil1/02.00.00_tension.html  IHS Classification ICHD-II Tension-type headache]</ref>
 
==Diagnosis==
Criteria for diagnosis are available.<ref name="IHS-II. Tension-type headache">International Headache Society. [http://ihs-classification.org/en/02_klassifikation/02_teil1/02.00.00_tension.html IHS Classification ICHD-II Tension-type headache]</ref><ref>Ad Hoc Committee on the Classification of Headache of the National  Institute of Neurological Diseases and Blindness. [http://jama.ama-assn.org/cgi/reprint/179/9/717 Classification of headache]. JAMA (1962) 179:717–8</ref>


==Prevention==
==Prevention==
It is not clear whether any medications taken daily can prevent tension headaches.<ref name="pmid20028727">{{cite journal| author=Verhagen AP, Damen L, Berger MY, Passchier J, Koes BW| title=Lack of benefit for prophylactic drugs of tension-type headache in adults: a systematic review. | journal=Fam Pract | year= 2010 | volume= 27 | issue= 2 | pages= 151-65 | pmid=20028727  
===Tricyclic antidepressant===
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=20028727 | doi=10.1093/fampra/cmp089 }} </ref>
[[Tricyclic antidepressant]]s may be effective and may be more effective than [[second-generation antidepressant]]s acccording to a [[systematic review]].<ref name="pmid20961988">{{cite journal| author=Jackson JL, Shimeall W, Sessums L, Dezee KJ, Becher D, Diemer M et al.| title=Tricyclic antidepressants and headaches: systematic review and meta-analysis. | journal=BMJ | year= 2010 | volume= 341 | issue=  | pages= c5222 | pmid=20961988 | doi=10.1136/bmj.c5222 | pmc=PMC2958257 | url= }} </ref> Another [[systematic review]] concluded that it is not clear whether any medications taken daily can prevent tension headaches.<ref name="pmid20028727">{{cite journal| author=Verhagen AP, Damen L, Berger MY, Passchier J, Koes BW| title=Lack of benefit for prophylactic drugs of tension-type headache in adults: a systematic review. | journal=Fam Pract | year= 2010 | volume= 27 | issue= 2 | pages= 151-65 | pmid=20028727 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=20028727 | doi=10.1093/fampra/cmp089 }} </ref> However, several randomized controlled trials of [[antidepressant agent]]s included in the systematic review were positive.
 
{| class="wikitable"
|+ Randomized controlled trials of amitriptyline cited by Verhagen et al for prevention of headache.<ref name="pmid20028727"/>
! Trial!! Author's conclusion
|-
| Ashina<ref name="pmid15109513">{{cite journal| author=Ashina S, Bendtsen L, Jensen R| title=Analgesic effect of amitriptyline in chronic tension-type headache is not directly related to serotonin reuptake inhibition. | journal=Pain | year= 2004 | volume= 108 | issue= 1-2 | pages= 108-14 | pmid=15109513 | doi=10.1016/j.pain.2003.12.012 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15109513 }} </ref><ref name="pmid11075846">{{cite journal| author=Bendtsen L, Jensen R| title=Amitriptyline reduces myofascial tenderness in patients with chronic tension-type headache. | journal=Cephalalgia | year= 2000 | volume= 20 | issue= 6 | pages= 603-10 | pmid=11075846 }} </ref>|| "The lower platelet 5-HT during treatment with [[citalopram]] than amitriptyline indicates that [[serotonin|5-HT]] reuptake was most effectively inhibited by citalopram. In contrast, [[amitriptyline]] was most effective in reduction of headache."
|-
| Göbel<ref name="pmid7892022">{{cite journal| author=Göbel H, Hamouz V, Hansen C, Heininger K, Hirsch S, Lindner V et al.| title=Chronic tension-type headache: amitriptyline reduces clinical headache-duration and experimental pain sensitivity but does not alter pericranial muscle activity readings. | journal=Pain | year= 1994 | volume= 59 | issue= 2 | pages= 241-9 | pmid=7892022 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7892022 }} </ref> || "In the amitriptyline group, a significant reduction in daily headache duration was already found in the 3rd week of treatment."
|-
| Holroyd<ref name="pmid2071723">{{cite journal| author=Holroyd KA, Nash JM, Pingel JD, Cordingley GE, Jerome A| title=A comparison of pharmacological (amitriptyline HCL) and nonpharmacological (cognitive-behavioral) therapies for chronic tension headaches. | journal=J Consult Clin Psychol | year= 1991 | volume= 59 | issue= 3 | pages= 387-93 | pmid=2071723 }} </ref> || "[[Cognitive-behavioral]] therapy and amitriptyline each yielded clinically significant improvements in headache activity...Neither treatment, however, eliminated headache problems.." (no placebo group)
|-
| Holroyd<ref name="pmid11325322">{{cite journal| author=Holroyd KA, O'Donnell FJ, Stensland M, Lipchik GL, Cordingley GE, Carlson BW| title=Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: a randomized controlled trial. | journal=JAMA | year= 2001 | volume= 285 | issue= 17 | pages= 2208-15 | pmid=11325322 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11325322 | pmc=PMC2128735 }} </ref>|| "Our results indicate that antidepressant medication and stress management therapy are each modestly effective in treating chronic tension-type headaches. "
|-
| Pfaffenrath<ref>Pfaffenrath et al. Efficacy and Tolerability of Amitriptylinoxide in the Treatment of Chronic Tension-Type Headache: A Multi-Centre Controlled Study Cephalalgia April 1994 14: 149-155, {{doi|10.1046/j.1468-2982.1994.1402149.x}}</ref>||"Treatment response occurred in 30.3% of the [[amitriptylinoxide]], 22.4% of the amitriptyline and 21.9% of the placebo group."
|}
 
===Botulinum toxin===
[[Botulinum toxin]]  may have small benefit.<ref name="pmid22535858">{{cite journal|  author=Jackson JL, Kuriyama A, Hayashino Y| title=Botulinum toxin A for  prophylactic treatment of migraine and tension headaches in adults: a  meta-analysis. | journal=JAMA | year= 2012 | volume= 307 | issue= 16 |  pages= 1736-45 | pmid=22535858 | doi=10.1001/jama.2012.505 | pmc= |  url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22535858  }} </ref>


==References==
==References==
<references/>
{{reflist|2}}
 
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Latest revision as of 16:00, 25 October 2024

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In medicine, tension headache, also called tension-type headache, stress headache or idiopathic headache, is a "common primary headache disorder, characterized by a dull, non-pulsatile, diffuse, band-like (or vice-like) pain of mild to moderate intensity in the head; scalp; or neck. the subtypes are classified by frequency and severity of symptoms. there is no clear cause even though it has been associated with muscle contraction and stress.[1][2]

Diagnosis

Criteria for diagnosis are available.[2][3]

Prevention

Tricyclic antidepressant

Tricyclic antidepressants may be effective and may be more effective than second-generation antidepressants acccording to a systematic review.[4] Another systematic review concluded that it is not clear whether any medications taken daily can prevent tension headaches.[5] However, several randomized controlled trials of antidepressant agents included in the systematic review were positive.

Randomized controlled trials of amitriptyline cited by Verhagen et al for prevention of headache.[5]
Trial Author's conclusion
Ashina[6][7] "The lower platelet 5-HT during treatment with citalopram than amitriptyline indicates that 5-HT reuptake was most effectively inhibited by citalopram. In contrast, amitriptyline was most effective in reduction of headache."
Göbel[8] "In the amitriptyline group, a significant reduction in daily headache duration was already found in the 3rd week of treatment."
Holroyd[9] "Cognitive-behavioral therapy and amitriptyline each yielded clinically significant improvements in headache activity...Neither treatment, however, eliminated headache problems.." (no placebo group)
Holroyd[10] "Our results indicate that antidepressant medication and stress management therapy are each modestly effective in treating chronic tension-type headaches. "
Pfaffenrath[11] "Treatment response occurred in 30.3% of the amitriptylinoxide, 22.4% of the amitriptyline and 21.9% of the placebo group."

Botulinum toxin

Botulinum toxin may have small benefit.[12]

References

  1. ↑ Anonymous (2024), Tension headache (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ 2.0 2.1 International Headache Society. IHS Classification ICHD-II Tension-type headache
  3. ↑ Ad Hoc Committee on the Classification of Headache of the National Institute of Neurological Diseases and Blindness. Classification of headache. JAMA (1962) 179:717–8
  4. ↑ Jackson JL, Shimeall W, Sessums L, Dezee KJ, Becher D, Diemer M et al. (2010). "Tricyclic antidepressants and headaches: systematic review and meta-analysis.". BMJ 341: c5222. DOI:10.1136/bmj.c5222. PMID 20961988. PMC PMC2958257. Research Blogging.
  5. ↑ 5.0 5.1 Verhagen AP, Damen L, Berger MY, Passchier J, Koes BW (2010). "Lack of benefit for prophylactic drugs of tension-type headache in adults: a systematic review.". Fam Pract 27 (2): 151-65. DOI:10.1093/fampra/cmp089. PMID 20028727. Research Blogging.
  6. ↑ Ashina S, Bendtsen L, Jensen R (2004). "Analgesic effect of amitriptyline in chronic tension-type headache is not directly related to serotonin reuptake inhibition.". Pain 108 (1-2): 108-14. DOI:10.1016/j.pain.2003.12.012. PMID 15109513. Research Blogging.
  7. ↑ Bendtsen L, Jensen R (2000). "Amitriptyline reduces myofascial tenderness in patients with chronic tension-type headache.". Cephalalgia 20 (6): 603-10. PMID 11075846.
  8. ↑ Göbel H, Hamouz V, Hansen C, Heininger K, Hirsch S, Lindner V et al. (1994). "Chronic tension-type headache: amitriptyline reduces clinical headache-duration and experimental pain sensitivity but does not alter pericranial muscle activity readings.". Pain 59 (2): 241-9. PMID 7892022.
  9. ↑ Holroyd KA, Nash JM, Pingel JD, Cordingley GE, Jerome A (1991). "A comparison of pharmacological (amitriptyline HCL) and nonpharmacological (cognitive-behavioral) therapies for chronic tension headaches.". J Consult Clin Psychol 59 (3): 387-93. PMID 2071723.
  10. ↑ Holroyd KA, O'Donnell FJ, Stensland M, Lipchik GL, Cordingley GE, Carlson BW (2001). "Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: a randomized controlled trial.". JAMA 285 (17): 2208-15. PMID 11325322. PMC PMC2128735.
  11. ↑ Pfaffenrath et al. Efficacy and Tolerability of Amitriptylinoxide in the Treatment of Chronic Tension-Type Headache: A Multi-Centre Controlled Study Cephalalgia April 1994 14: 149-155, DOI:10.1046/j.1468-2982.1994.1402149.x
  12. ↑ Jackson JL, Kuriyama A, Hayashino Y (2012). "Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: a meta-analysis.". JAMA 307 (16): 1736-45. DOI:10.1001/jama.2012.505. PMID 22535858. Research Blogging.
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