Each of us has encountered such an unpleasant phenomenon as headaches. Their nature and forms may be different. The most common type is tension headaches. We will consider the symptoms, treatment and causes of this phenomenon in the article.

This disease affects a third of all people on our planet. In most patients, this condition develops at a young age; if the disease occurs after 50 years, then this is rather an exception. Women are more likely to experience tension headaches than men. ICD-10, or the international classification of diseases, assigns code G44.2 to this pathology.

Forms of the disease

There are two types of tension headaches:

Episodic, developing as a result of stressful situations of low intensity. A tension headache can last for a few minutes or several days. The symptoms in this case are as follows: moderate pain, which is eliminated by popular medications. This condition does not have a significant impact on the quality of life.

Chronic tension headache symptoms have the following: painful sensations, most often bilateral, they are localized in the occipital-frontal region. This pain develops as a result of spasm of the muscles of the neck and head. Chronic tension headaches are quite intense and monotonous.

The clinical picture of the two forms of the disease is the same, only their duration is different.

Signs of the disease

How does a tension headache manifest? The symptoms of this disease, in addition to pain, include weakness, fatigue, irritability, nervousness, and fatigue. But this pain is not throbbing, and does not cause nausea and vomiting. Many patients are diagnosed with intolerance to noise and light, they complain of lack of appetite, insomnia, and absent-mindedness.

Patients define such pain as squeezing and squeezing, tightening and monotonous, dull and mild, moderate and severe.

Some patients may experience discomfort when combing their hair or wearing a hat. The pain does not subside even at night, but it does not intensify with physical activity. When palpating the muscles of the neck and head, compactions are felt. The pathology can develop at any age; tension headaches often occur in children; this is associated with mental overload.

Headache with muscle tension

Tension headaches are common among people of working age. Other names: idiopathic, psychogenic headache.

The cause of this condition is prolonged contraction of the muscles of the face, neck, and skull. This leads to a decrease in the volume of blood flow in the vessels. As a result, oxygen starvation of muscle tissue may develop. As a result, toxins accumulate and tension headaches occur. The symptoms in this case are as follows:

severe tension in the facial, neck and shoulder muscles;

dull, non-pulsating pain going to the forehead from the back of the head;

sensation of powerful tension in the forehead and temples.

In old age, the development of such pain is atypical.

Headache due to nervous tension

Nervous tension headaches are usually pronounced. A person in such a state cannot relax. Pain is a consequence of nervous overload and frequent conflict situations.

If you distract from factors traumatic to the soul, painful sensations may stop or weaken. For example, relaxing with loved ones, a trip to nature, or watching a light movie will help improve your well-being.

Lesions of the nervous system are not detected during examination, and human health, in general, is not threatened. However, painful sensations greatly reduce the quality of life, and the patient needs medical attention.

How to normalize the condition?

If a headache or discomfort occurs as a result of nervous overload? In this case, it is very important to be able to relax. This can be done in several ways, namely:

do auto training and yoga;

undergo several psychotherapy sessions;

take with the addition of medicinal herbs or stand under hot water in the shower;

massage your neck;

undergo a course of physiotherapy;

regularly do therapeutic exercises.



Physical overload and tension headaches

Quite often, a painful sensation in the head area develops as a result of physical stress. As a rule, this is due to a person’s professional responsibilities: working at a computer or driving a car for a long time. Eye strain develops in jewelry and watchmakers, seamstresses, assemblers of small electronic components, etc.

Such people should take breaks from work more often, change their position, and self-massage problem areas.

If the child has a problem

Today, children are no less likely than adults to develop tension headaches. The symptoms in this case are the same: bilateral squeezing pain, the child becomes irritable and gets tired quickly. Often such unpleasant sensations are complemented by pain in the back and neck, in the heart and joints, blood pressure rises or, conversely, falls, and the heartbeat quickens.

The cause of prolonged muscle tension is a desk or desk that is not suitable for height, resulting in the child being in an uncomfortable position for a long time. Stuffiness in the room, mental and physical fatigue, forced long-term fasting, and weather disasters also contribute to the occurrence of pain.



Causes

Most of the causes of this condition have already been described above. Also, provoking factors of the disease can be:

anxiety, depression and other affective conditions;

muscle stress if a person does not move for a long time (overstrain of the facial, eye, neck muscles);

frequent use of analgesics and tranquilizers;

• sudden change in weather conditions;

incorrect posture, uncomfortable body position during sleep;

in case of respiratory disorders, the result is pain in the head;

diseases of the cervical spine;

excessive consumption of alcohol and caffeinated drinks.

tension: treatment

Reviews of methods for eliminating headaches may vary. Because every body is individual, and what works well for one person is completely unsuitable for another. How to treat tension headaches? An integrated approach is very important here. That is, therapy should consist not only of pain relief, but also of eliminating the cause of the condition. If there is tension, treatment primarily consists of:

prevention of stress, anxiety, mental overload, depression;

eliminating muscle tension;

preventing side effects from pain medications.

Drug therapy

For this pathology, the following medications are used:



Combination of tension headache and abuse headache

When using pharmaceuticals, you should strictly adhere to the treatment regimen recommended by your doctor. Uncontrolled use of medications, especially non-steroidal drugs, can cause abusive headaches. That is, the drugs themselves cause it. To differentiate this condition from a tension headache, the drug that caused the abuse should be discontinued for 2 months. If after this normalization of well-being does not occur, a diagnosis of “chronic tension headache” is made. If, after discontinuation of medications, the patient’s condition noticeably improves, then abuse pain occurs.

Combination of tension headache and migraine

Some patients experience a combination of episodic tension-type headaches and episodic migraines. As a rule, such people suffer from frequent migraines. And over time, they develop tension headaches. These two forms of pathology have different symptoms, so distinguishing one from the other is not difficult.

In the case of chronic migraine, attacks become atypical. And then it can be difficult to distinguish chronic migraine from chronic tension headache. In such a situation, the patient is asked to keep a diary and, for a long time (about 2 months), note in it the clinical manifestations, alleviating and provoking factors of each attack. This will simplify the further establishment of an accurate diagnosis.



Non-drug treatments

For a condition such as tension headache, treatment can be carried out without the use of drugs. There are more gentle methods, these include:

relaxation of the body;

relaxing massage of tense muscles;

acupuncture.

Traditional medicine in the fight against such a condition as tension headache: treatment, reviews

This type of headache is not particularly intense, but it can disrupt a person’s normal psycho-emotional state for a long time. The following recommendations will help reduce the symptoms of an attack:

You need to relax as much as possible, if possible, leave your workplace and step away from the computer for a few minutes.

In a stressful situation, you should calm down and brew a cup of herbal tea. According to patient reviews, an infusion of thyme herb not only perfectly strengthens the nerves, but also has a beneficial effect on the activity of blood vessels in the brain. To prepare a healing drink, add 0.5 liters of boiling water to 5 grams of herb and leave for 30 minutes. Take the resulting infusion three times a day for a week, then take a break for 14 days.

When treating this ailment, patients note the high effectiveness of the following exercise: while inhaling, exhaling, slowly draw in. The exhalation should last twice as long as the inhalation. The procedure should be carried out within 15 minutes. By the way, with the help of this exercise you can significantly tighten your sagging abdominal muscles.

A massage of the collar area and head will significantly improve your well-being. You can do it yourself - with your fingers or a comb.

Many patients note a decrease in pain after a good long sleep or taking a relaxing bath.

A cold compress applied to the forehead area has a good effect. For it, you can use the golden mustache plant, cabbage leaf or beet pulp.



Preventive actions

For some people, a painful feeling in the head area can occur quite often, in this case a chronic tension headache occurs. And often patients take quite a large number of medications to normalize their condition, which, in turn, can provoke new attacks. Therefore, it is important to know how to prevent the development of such pathology.

Prevention is as follows:

Complete rest at night. Every person should sleep at least eight hours a day. Experts recommend going to bed no later than 11 p.m. It is from 11 pm to 1 am that the body regains strength.

To prevent the development of muscle tension during work, it is recommended to take a break every hour and perform gymnastics for all parts of the musculoskeletal system.

Be sure to take daily walks in the fresh air.

Regular physical activity not only improves health, but also minimizes the negative impact of stressful situations.

To improve the general condition of the body, it is recommended to undergo treatment with decoctions of soothing medicinal herbs, such plants include valerian, motherwort, and peony tincture.

The consumption of coffee and alcoholic beverages should be kept to a minimum.

Forecast

Rarely occurring episodic headaches do not particularly affect a person’s performance and well-being. If the number of attacks per month increases, this is worth paying attention to. Since in this case the disease can become chronic, resulting in the development of psycho-emotional instability and depression. The prognosis depends on how timely drug therapy was started; in especially severe cases, treatment with antidepressants can last up to six months.

If it is revealed that the cause of the pain is dependence on painkillers, then therapy requires a different approach. It is necessary to conduct a thorough medical examination, based on the results of which a specialist will recommend an effective course of treatment with other medications.

Conclusion

After reading this article, you have learned more about the phenomenon of tension headaches. Symptoms, types, causes and principles of treatment of the pathological condition have been described above. Remember that positive emotions have a beneficial effect on the state of the whole organism, and when they prevail over negative ones, headaches develop much less frequently. Try to always maintain a good mood and good spirits, do not harbor feelings of resentment and anger in your soul, approach life with ease and ease - and then your emotional state will always be normal. Be healthy!

The most popular form of headache, which manifests itself in long episodes, the duration of which ranges from several minutes to several days. The prevalence of tension headaches is described very vaguely - throughout life in the general population from 30 to 78%.

Tension headaches are different:

• bilateral localization,
• compressive or squeezing character,
• light or moderate intensity,
• remains the same during normal physical activity,
• not accompanied by nausea,
• Possible photo- or phonophobia.

A tension headache is called episodic if it occurs no more than 15 days during the month (or less than 180 days during the year). If this indicator is exceeded, then tension headache is defined as chronic. A more detailed classification of tension headaches includes:

• infrequent episodic
• infrequent episodic with tension of the pericranial muscles,
• infrequent episodic without tension of the pericranial muscles,
• frequent episodic
• frequent episodic with tension of the pericranial muscles,
• frequent episodic without tension of the pericranial muscles,
• chronic
• chronic with tension of the pericranial muscles,
• chronic without tension of the pericranial muscles,
• possible tension headache,
• probably infrequent episodic,
• probably frequent episodic,
• probably chronic.

This is usually a non-pulsating, squeezing “hoop” or “helmet” type pain, often appearing soon after waking up and present throughout the day in rolling waves - sometimes stronger, sometimes weaker. Patients experience:

• increased anxiety,
• reduced mood background,
• melancholy and apathy,
• aggressiveness and irritability,
• poor quality of night sleep.

Painful sensations are often not limited to localization in the head, but from the back of the head radiate to the back surface of the neck and shoulder girdle - this is how muscle-tonic syndrome is formed.

Among the main causes of tension headaches are:

• “muscle factor” (a peculiar consequence of a long forced position of the neck and head in a certain uncomfortable position),
• emotional stress as a provocateur of muscle spasm.

If tension headaches were previously assessed as more of a psychogenic disorder, modern research points to its neurobiological nature. In pathogenesis, the role of mechanisms is noted:

• peripheral
• central nociceptive (decreased activity of the antinociceptive system, insufficiency of inhibitory mechanisms of the brain stem).

If a tension headache is associated with tension in the pericranial muscles, then muscular-tonic syndrome is formed. This is a kind of “vicious circle” when muscle tension occurs in response to emotional stress, and this in turn generates reflex muscle tension (spasm). As a result, the excitability of nociceptive neurons in the structures of the central nervous system increases, prolonged tonic tension leads to hypoxia and inflammation of the muscle, then secondary hyperalgesia is formed, it increases muscle spasm and causes chronic tension pain.

How to treat tension headaches?

First of all, it requires behavioral therapy. An explanatory conversation is held with the patient, during which the benign nature of the headache is explained, which is not associated with functional disorders in the brain or cerebral vessels. It is important to clarify the mechanism of formation of cephalalgia. For patients with chronic pain who have abused painkillers, the importance of drug abuse in the chronicity of headaches is explained.

In general, the treatment of tension headaches is a set of measures aimed at normalizing the patient’s emotional state and eliminating muscle tension, and, if necessary, correcting other comorbid disorders and drug abuse. There are two approaches to solving the problem - pain relief during the next attack and pain prevention in order to reduce the frequency of symptoms over a long life period.

Symptomatic treatment of a painful episode (or relief of attacks) with over-the-counter analgesics is relevant in the case of episodic headache with a frequency of attacks no more than 2 times a week (8 painful days per month) - the drugs of choice are those whose active ingredient is acetylsalicylic acid, ibuprofen, paracetamol, diclofenac.

As part of the preventive treatment of tension headaches, the relevance of which makes sense for chronic manifestations of pain, amitriptyline or nortiptyline is used.

If a patient's examination indicates that he has anxiety-depressive disorders, it is permissible to prescribe antidepressants (paroxetine, fluoxetine, escitalopram, fluvoxamine, venlafaxine, duloxetine) in doses generally accepted for the treatment of depression. Patients with severe pain and tension in the pericranial muscles may be prescribed muscle relaxants.

If a tension headache is combined with migraine attacks, the doctor will write a prescription for beta-blockers, nonsteroidal anti-inflammatory drugs, and calcium channel blockers. Such medications primarily demonstrate effectiveness against migraine.

It is good if complex therapy for tension headaches is complemented by non-drug methods. This increases the likelihood of successful headache prevention. Applicable:

• psychotherapy and psychological relaxation,
• biofeedback,
• post-isometric muscle relaxation,
• massage of the collar area,
• fitness, water procedures.

What diseases can it be associated with?

A headache itself can be a symptom of many diseases - from the banal to the structure of the brain. However, if the established diagnosis sounds like a tension headache and it is of a primary nature, then it is an independent disorder, a pain syndrome that is interconnected with the emotional state of the patient and the presence of muscle tension.

Treating tension headaches at home

Successfully carried out at home. It would be useful for the patient to be registered with the attending doctor, who will monitor and, if necessary, adjust the course of treatment. In mild cases, even self-medication is allowed - taking analgesic, antispasmodic drugs, but not abusing them. In addition, consultation with a professional doctor is necessary to exclude dangerous functional disorders, in which headache can only be a symptom.

Important components of therapy, along with explaining to the patient the mechanisms of the origin of pain and strategies for eliminating it, are training in psychological and muscle relaxation techniques.

What medications are used to treat tension headaches?

To relieve a headache attack:

• acetylsalicylic acid - 600-1000 mg each,
• ibuprofen - 400-800 mg,
• paracetamol - 100 mg,
• diclofenac - 50-100 mg,
• flupirtine - 100 mg.

To prevent the onset of pain:

• amitriptyline - 10-100 mg,
• nortiptyline - 10-100 mg,
• tizanidine - 2-6 mg per day,
• baclofen - 10-25 mg 2-3 times a day.

Treatment of tension headaches with traditional methods

Folk tension headache treatment The goal is to relax and calm, eliminate muscle spasms, and relieve pain. For this purpose, a variety of essential oils can be used for massages and rubbing, as well as herbal decoctions for oral administration and water procedures:

use for baths

• Dissolve 100 grams of sea salt in warm water, add 2 tbsp. pine extract (sold in a pharmacy); take a bath daily for 10 days;
• Brew 200 grams of pine needles (you can use literally dried Christmas tree needles, or you can buy a pine collection at the pharmacy) in 5 liters of water, after 5 minutes on the fire, strain and pour the broth into a warm bath; take before bedtime;
• Brew a handful of dried lavender with a glass of boiling water, after half an hour pour the infusion into a warm bath; Great for helping you relax and relieve tension;

use essential oils for massages

• mint,
• menthol,
• cedar,
• eucalyptus,
• cypress,
• incense,
• juniper, etc.;

for oral use

• combine 75 grams of grated horseradish, ½ large leaf of golden mustache, 250 grams of oranges (chopped with zest), 150 grams of sugar and 1/2 liter of red wine; place in a water bath for 1 hour, remove, strain; take 75 ml 2 hours after each meal.
• Place 15 grams of dried lemon balm in a thermos, brew a glass of boiling water, leave for about an hour, strain; take 1-2 tablespoons 5-6 times a day;
• 1 tbsp. St. John's wort pour a glass of boiling water, simmer for 15 minutes, strain; take ¼ cup 3 times a day.

Treatment of tension headaches during pregnancy

Treatment for tension headaches during pregnancy, it is carried out according to the standard scheme, however, the admissibility of certain medications should be discussed with the gynecologist leading the pregnancy or the neurologist who previously observed the woman. Treatment during pregnancy has the main goal - to normalize the well-being of the expectant mother, eliminate pain, so as not to disturb the usual state.

Which doctors should you contact if you have a tension headache?

In a medical office, when complaining of a headache that falls under the category of tension, a clinical diagnosis is usually made, which turns out to be quite sufficient. Instrumental methods and consultations with specialists are indicated only if the secondary nature of cephalgia is suspected. Then their goal will be to identify the root cause of the developing syndrome.

An important element of the examination of a patient with tension headache is the examination of the pericranial muscles. For this purpose the following is used:

• normal palpation
• electromyography with surface electrodes,
• algometry.

The palpation method is the most sensitive for detecting dysfunction of the pericranial muscles in patients with migraines or tension headaches. Dysfunction of the pericranial muscles is easy to determine by palpation; it is produced by small rotational movements of the II and III fingers, as well as by pressing in the area of ​​the frontal, temporal, masticatory, sternocleidomastoid and trapezius muscles. The presence of dysfunction is certainly taken into account when choosing a treatment strategy.

Criteria for diagnosing tension headaches

• the duration of the attack is from 30 minutes to a full week;
• two-way localization;
• pressing/squeezing/non-pulsating character;
• light to moderate intensity;
• no increase in pain during normal physical activity (walking, climbing stairs);
• no nausea or vomiting;
• occasionally photo- or phonophobia;
• pain relief with positive emotions and in a state of psychological relaxation;
• increased pain due to emotional experiences.

Treatment of other diseases starting with the letter - g

A tension headache is a condition in which a person feels pressure, tension, or a dull discomfort in the scalp.

Soreness can bother a person for varying durations - from several minutes to days, with periods of decreasing and exacerbating discomfort.

The prevalence of HDN in modern society is striking in its scope: according to some data, its incidence reaches 65% among the male population and 86% among the female population.

The causes of tension headaches are overwork, stress, prolonged forced positioning in an uncomfortable position, anxiety disorders, depression, long-term use of analgesics and tranquilizers. More often there is a combination of provoking factors. We will look at the symptoms and treatment of this problem in this article.

Classification

Why do tension headaches occur and what are they? First, pain is divided into episodic and chronic.

1. Episodic pain. With this type of tension headache, a person experiences pain no more than 20 days a month or 180 days a year. The intensity of episodic pain will be low.
2. About chronic pain tension is said to be when attacks take more than 15 days a month, this form is characterized by greater intensity of symptoms.

Despite the fact that the differences in these types of tension headaches are very arbitrary, they help the doctor to navigate and give the patient the correct diagnosis.

Causes

Today, we can identify a huge number of factors that can provoke such pain. So, what can cause tension headaches?

1. Psychological stress, as well as various states of affect, such as deep depression or severe anxiety. We must not forget that depression can be expressed in both open and closed forms. In other words, in some cases the patient simply does not recognize that he is depressed, and therefore categorically refuses any course of treatment. It is precisely such cases that are most dangerous, because they can most often cause serious headaches. In situations where headaches occur precisely because of psychological stress, the patient may also complain of impaired appetite and sleep, irritability and fatigue.
2. The second most common cause of tension headaches is muscle stress. It represents prolonged muscle tension when a person does not move for a long time. Muscle tension headaches are most often caused by overstrain of the neck, eye muscles, as well as the muscles of the shoulder girdle and scalp aponeurosis.
3. Headaches can be triggered by excessive consumption of tranquilizers, analgesics containing acetylsalicylic acid, etc. You need to be extremely careful when taking such drugs!

People with specific work activities are especially likely to develop tension headaches. This category includes drivers, accountants and other people who spend a lot of time in front of a computer monitor. There is also a high risk of this disease in watchmakers, jewelers and other professions that constantly strain the visual muscles.

Tension headache symptoms

Tension headaches usually have specific symptoms. People describe the symptoms as squeezing or pressure (like a tight band around the head, a squeezing belt, or like a hat that is too small). The pain is usually bilateral and often radiates down or up from the neck.

The pain is usually mild to moderate, but can sometimes be so intense that it interferes with daily activities. There are usually no other symptoms, although some people with tension headaches dislike bright lights and loud noises and have a decreased appetite.

Criteria for diagnosing tension headaches have been developed; it is distinguished by the following symptoms:

• compressive or squeezing character;
• light or moderate intensity;
• remains the same during normal physical activity;
• not accompanied by nausea;
• Possible photo- or phonophobia.

In order for a diagnosis to be made, at least two of the above characteristics must be present.

What medications can be used to relieve tension headaches?

For stopping an attack, as well as relieving headaches, is used:

• – 400-800 mg each;
• – 600-1000 mg each;
• – 100 mg each;
• – 50-100 mg;
• flupirtine – 100 mg.

For prevention of the onset pain syndrome:

• – 10-100 mg;
• nortiptyline – 10-100 mg;
• tizanidine – 2-6 mg per day;
• baclofen – 10-25 mg 2-3 times a day.

They help get rid of headaches that have arisen under the influence of provoking factors. Today it has been established that none of the analgesics can relieve hypertension in everyone without exception, and each patient requires individual selection of the drug.

But we must not forget that by using painkillers for too long, you can get the opposite effect - an overuse headache (i.e., these drugs themselves cause it), so you need to be very careful when using medications in the treatment of tension headaches.

Treatment of tension headaches

When tension headaches appear, treatment involves first of all identifying and eliminating the causes of their occurrence. The complex treatment procedure must be prescribed by a doctor; in most cases, it is a combination of relaxation and medications.

1. The main place in treatment is the normalization of the patient’s emotional state. It is necessary to adequately approach the treatment of depression, phobia, and anxiety. This is why most patients are prescribed antidepressant drugs (amitriptyline, fluoxetine, venlafaxine).
2. To relieve muscle tension, muscle relaxants (tizanidine) are prescribed.
3. NSAIDs (diclofenac, acetylsalicylic acid, naproxen) are also taken only as adjuncts, and only for a short time, symptomatically.

The basic principles of non-drug treatment for tension headaches are as follows:

1. You need to sleep at least 7-8 hours a day. If you need to get up early in the morning, go to bed early.
2. Try to eat well (at least 3-4 times a day) and drink at least 2 liters of clean water per day (except tea, coffee and alcoholic beverages).
3. When working at a computer for a long time, you definitely need to take breaks and be distracted somehow. Eye exercises and a little physical warm-up will be effective.
4. Try to move more and spend more time in the fresh air.

Acupuncture, manual therapy, massage, relaxation therapy, and biofeedback are also used. Your doctor should tell you how to get rid of severe tension headaches. You need to be prepared for the fact that the treatment course can last for 2-3 months.

Prevention

You can prevent them by the following methods:

• psychotherapy and physiotherapeutic procedures;
• water procedures and manual therapy;
• health improvement at resorts;
• choose the optimal mode of work and rest;
• constantly engage in physical therapy;
• strict adherence to doctor's instructions.

Medications include muscle relaxants and antidepressants, which only your doctor can prescribe.

Shoshina Vera Nikolaevna

Therapist, education: Northern Medical University. Work experience 10 years.

Articles written

Tension headache (TTH) is a fairly common type of headache. This disease, according to medical statistics, is diagnosed in more than 70% of the world's population. Despite its prevalence, this diagnosis raises questions among most people. What are tension headaches, what are the symptoms, and what is the treatment?

Hwhat is this?

Tension headache (muscle tension headache, tension headache, tensor headache) in medical terminology is listed as a separate diagnosis. It is a bilateral (one-sided) diffuse pain with moderate intensity.

Pain can form in any area - on the crown, forehead, or flow from one area to another. Often the tension is transmitted to the cervical and shoulder regions.

A connection indicating that tensor headache is a consequence of the patient’s existing pathologies has not been established, so doctors classify it as a primary disease.

TTH is characterized by sensations. People complain mainly about discomfort - it’s like a vice is encircling their head, and they want to get rid of them immediately. Tension headaches intensify from any touch to the head: a hat, a comb, even from a light breeze, but the intensity does not increase from physical activity.

Patients suffering from tension-type headache experience nervousness, their sleep and appetite are disturbed, and they are uncomfortable with sharp sounds, noise and bright lighting. The pain usually occurs during the day and does not bother you at night. Nausea, vomiting, and other symptoms typical, for example, are not observed.

INides

There are two types of TTH - episodic and chronic (depending on the duration and degree of pain symptoms).

The first type is characterized by a headache lasting 30 minutes. Number of attacks: up to 10 per month – infrequent, up to 15 – frequent. In total - up to 180 attacks per year.

The pain is moderate, of a compressive nature.

If attacks occur more than 15 times a month or more than 180 times a year, this is a chronic type of tension-type headache, characterized by intense pain. If the episodic form is not treated in a timely manner, the patient develops chronic tension headache.

TOis at risk

According to the observations of doctors, tension-type headache can occur in people of all ages, even small ones, but most often it develops in women 30-40 years old. At the same time, we can safely say that knowledge workers are at risk. The working day of such employees is associated with high concentration, emotional stress, concentration in conditions of sedentary work and little physical activity. Increasing pain does not allow a person to work fully, and accordingly, labor productivity decreases.

It is noteworthy that tension headaches cause disability for a huge number of people in the world. In Europe alone, annual government budget losses associated with employee disability amount to more than $15 billion.

The vast majority of the population is in no hurry to seek professional medical help, preferring to treat tension in the head on their own with painkillers, not taking into account that medications should be prescribed by a specialist. Such a negligent attitude towards one’s own health leads to a deterioration of the condition, the transition of episodic tension-type headache to the chronic stage.

There are a lot of factors leading to the occurrence of HDN. The most common are:

1. Stressful situations that affect the emotional state.
2. Irregularity, lack or excess of sleep.
3. Unbalanced diet.
4. Long-term use of certain medications.
5. Muscle tension due to the head and neck being in one position for a long time.
6. Lack of physical activity.
7. Lack of fresh air.
8. Climatic conditions (pressure changes, sudden changes in weather).

With tension headaches, all factors can be interrelated, while clear pain associated with mental stress can always be traced.

Methods for diagnosing tension headaches

The diagnosis is preceded by. Sometimes the doctor recommends that the patient keep a diary, which records the frequency, duration and characteristics of the headache that occurs. The records are then carefully analyzed.

Based on examination and palpation, soreness of the pericranial muscles is determined. More reliable information is obtained by using modern diagnostic methods. The therapist’s task is to determine whether a given illness is a symptom of another disease. The following must be carried out:

);
• tomography (CT);
• rheoencephalography (REG);
• ultrasound examination of the vessels of the head ();
• X-ray of the skull and cervical spine.

The use of a pressor algometer allows one to measure sensitivity thresholds to pain caused by pressure on tissue, but there are very few medical institutions that have this technical device.

How to Treat Episodic Tension Headaches

Treatment for episodic TTH will vary depending on the number of attacks per month.

For infrequent pain, therapy includes the use of non-steroidal anti-inflammatory drugs (Ibuprofen, Ketaprofen, Meloxicam, Naproxen, etc.). Medicines are taken no more than 10 times a month to avoid the development of headaches caused by long-term use of medications.

If the headache is frequent, a course of non-steroidal anti-inflammatory drugs is indicated as prescribed by the attending physician. If this measure turns out to be ineffective, then there is no point in repeating the course.

Muscle tension headache (TMS) is treated with muscle relaxants, such as Tolperisone, Sirdalud, Mydocalm, Tizanidine in combination with Aspirin. For frequent attacks, muscle relaxants are taken in a course.

It is also necessary to use additional medications: nootropic (Phenibut, Glycine), sedatives (to relieve anxiety, regulate the processes of autonomic function), B vitamins (Milgamma).

Recently, a method of treatment such as biofeedback using computer technology has been actively used.

Pain treatment xrhonic type

Painkillers are not used for the treatment of chronic tension-type headache, since they are no longer effective against the pain syndrome.

Tension headaches are treated with antidepressants, prescribed individually in each case:

1. Trilic (Amitriptyline) course from 2 to 6 months. The dosage is gradually increased, then, when the desired result is achieved, it is reduced and canceled completely.
2. New generation antidepressants (Fluoxetine, Paxil, Sirlift, etc.). They are considered more effective and are easily tolerated by the body (without side effects).
3. Other antidepressants (Mianserin, Coaxal, etc.).

The use of antidepressants allows you to relieve pain and eliminate the cause that caused it, as the number of attacks and intensity of pain decrease, mental state improves, and mood stabilizes.

You need to understand that tension pain that has developed in the head requires a long healing process.

Non-pharmacological treatments

1. Water procedures, including contrast showers, warm relaxing baths with herbs, cool foot baths, compresses. If there are no contraindications, saunas and steam baths are indicated.
2. Breathing exercises, auto-training to achieve complete relaxation.
3. Manual therapy, massage of the back and cervical-collar area. Patients note that even one correctly performed session allows them to forget about headaches. It is very important that the patient feels only pleasant relaxation. Pain and discomfort during massage are unacceptable.
4. Aromatherapy with essential oils (rose, lavender, cypress, grapefruit).
5. Physical therapy classes (under the guidance of an instructor).
6. Acupuncture.
7. Psychorelaxation.
8. Electrosleep.

How to treat tension headaches with? Some have proven themselves well, so they should not be neglected either. The most common method that our grandmothers used is chamomile tea to eliminate fatigue and anxiety. Instead of chamomile, you can use lemon balm, mint, sage, rosemary. Herbs are natural healers!

How to relieve tension headaches with a regular cabbage leaf? To do this, you need to take a fresh cabbage leaf, lightly knead it with your hands and secure it to the sore area with a scarf.

Preventive actions

Any disease is easier to prevent than to treat. You will never know what a tension headache is if you follow simple but very effective prevention measures:

1. Get adequate sleep (at least 8 hours). Before going to bed, the room should be thoroughly ventilated, the mattress and pillow should be comfortable, ideally orthopedic. A person should wake up completely rested.
2. Balanced diet. The diet should be enriched with fiber. It is advisable to “lean” on greens, vegetables, fruits, grains, and seafood. But it is advisable to exclude smoked meats, sausages, fast food, fried and spicy foods from the menu.
3. Maintaining water balance. The optimal amount of water consumed is 1.5 liters per day.
4. Stabilization of stomach and intestinal functions. You need to eat at certain hours to avoid constipation and autointoxication.
5. Reducing the consumption of coffee, strong alcohol, beer, cigarettes, including electronic ones.
6. Walks in the fresh air, preferably before bedtime; reasonable sports activity to increase physical activity.

And, of course, during the working day you need to take short breaks every hour, especially if the work involves mental activity. Five minutes is enough to rest and gain strength.

If primary signs of the disease appear, you need to try to achieve complete relaxation and relieve pain using improvised methods: by warming up the cervical spine.

Are tension headaches making themselves felt more and more often? Contact a specialist immediately.

Why you need to know about tension headaches: among cephalgia (headaches), tension headache occupies a leading position - its prevalence in the population reaches 70%, but at the same time, it is also underdiagnosed, which entails the use of treatment and prevention methods that are inadequate for this headache and, accordingly, the chronicization of cephalgia, significantly reducing the quality of life.

The main causes of tension headaches are believed to be muscle tension, genetic predisposition, environmental influences and psychological mechanisms.

An attack of tension headache can occur in any practically healthy person due to physical stress: for example, due to intense training in the gym without prior preparation and non-physiological posture during work, if a person refuses sleep or rest - relaxation, in these cases the primary cause of pain is increased nociceptive (pain) impulses from tense (overstrained) muscles. Tension headaches can occur not only as excessive activity of the nociceptive system, but also as a consequence (result) of insufficiency of antinociceptive (anti-pain) mechanisms due to stress, anxiety, depression and other emotional disorders .

Chronic tension headaches are promoted by sensitization in the trigeminal system (the trigeminal nerve is one of the main sensory cranial structures) due to prolonged nociceptive stimulation from the periphery. Thus, the muscle factor is important not only for the occurrence of an acute episode of tension headache, but is also no less important for the chronicity of tension headache.

Definition(definition) of tension-type headache (hereinafter referred to as TTH) is carried out using diagnostic criteria that are published in the International Classification of Headache Pain (ICHD-III, 2013).

And so, tension-type headache is always a bilateral squeezing, tightening, squeezing, but not pulsating, headache with a duration of its episode of at least 30 minutes (no more than 7 days), which is not aggravated by the usual daily physical activity, but negatively affects everyday life. and professional activities and sometimes accompanied by symptoms such as phonophobia or photophobia, anorexia or nausea, which are not present all together (as in migraine), except in cases of severe chronicity.

Diagnostic criteria for tension headache, regardless of its type(see below) except point D:

… WITH. A headache has at least two of the following characteristics:

■ two-way localization;
■ compressive / pressing (non-pulsating) nature;
■ pain intensity is mild to moderate;
■ the headache is not worsened by normal physical activity (for example, walking, climbing stairs) ...

■ absence of nausea or vomiting (possible loss of appetite);
■ only photophobia or only phonophobia...

■ only one symptom out of three: photophobia or phonophobia or mild nausea;
■ the headache is not accompanied by either moderate or severe nausea or vomiting...

Thus, if a headache with tension-type symptoms occurs in close association with another disease that causes these symptoms, then such a headache should be coded as a secondary headache (as a consequence of this disease). It must be remembered that existing (proven) secondary headache does not exclude the possibility of simultaneous existence of tension-type headache.

Depending on the number of “pain days” per month (and/or per year), HDN is divided into infrequent episodic[EGBN] (no more than 1 day per month / 12 days per year), frequent episodic(from 1 to 15 days per month / from 12 to 180 days per year) and chronic [CHFN] (at least 15 days per month for an average of more than 3 months / at least 180 days per year).

Criteria for diagnosing tension-type headache according to ICHD version 3 beta, 2013:

2. Tension headache (TTH)

2.1 Uncommon episodic tension-type headache

Description: infrequent episodes of headache, lasting from several minutes to several days. The pain is usually bilateral, squeezing or pressing in nature, mild or moderate intensity, does not intensify with normal physical activity; the pain is not accompanied by nausea, but photophobia or phonophobia may be observed.

Diagnostic criteria:

A. At least 10 episodes occurring 1 day per month (up to 12 days per year) and meeting criteria B-D.
B. The headache lasts from 30 minutes to 7 days.

2.1.1 Uncommon episodic tension headache associated with pericranial muscle tension

A. The headache meets the criteria for 2.1 Infrequent episodic tension-type headache B. Increased tension of the pericranial muscles on palpation.

2.1.2 Uncommon episodic tension-type headache not associated with pericranial muscle tension.

A. The headache meets the criteria for 2.1. Infrequent episodic tension-type headache. B. No tension of the pericranial muscles on palpation.

2.2 Frequent episodic tension headaches

Diagnostic criteria:

A. At least 10 episodes occurring at a frequency of 1 to 14 days per month for >3 months (12 to 180 days per year) and meeting criteria B-D.
B. Duration from 30 minutes to 7 days.
C. Headache has two or more of the following 4 characteristics: 1. Bilateral localization 2. Constrictive (non-pulsating) in nature 3. Mild to moderate intensity 4. Not worsened by normal physical activity.
D. Both of the following criteria: 1. No nausea or vomiting (may have decreased appetite) 2. Either photophobia or phonophobia.
E. Headache does not correspond to a greater extent to another diagnosis from ICHD-3 beta.

2.2.1 Frequent episodic tension headaches associated with pericranial muscle tension

A. Headache meets criteria for 2.2 Frequent episodic tension-type headache B. Increased tension of the pericranial muscles on palpation.

2.2.2 Frequent episodic tension headaches not associated with pericranial muscle tension

A. Headache meets criteria for 2.1 Frequent episodic tension-type headache B. No tension of the pericranial muscles on palpation.

2.3 Chronic tension headache

Description: A disorder originating from episodic tension-type headache and characterized by very frequent or daily episodes of headache lasting from a few minutes to several days.

Diagnostic criteria:

A. Headache occurs with a frequency of 15 or more days/month for an average of >3 months (>180 days/year), meets criteria B-D.
B. Lasts from several hours to several days or is continuous.
C. Two or more of the following 4 characteristics: 1. Bilateral localization 2. contractive/non-pulsatile in nature 3. Mild to moderate intensity 4. Not aggravated by normal physical activity.
D. Both of the following: 1. not >1 of the following: photophobia, phonophobia, mild nausea 2. No moderate or severe nausea or vomiting.
E. Headache does not correspond to a greater extent to another diagnosis from ICHD-3 beta.

2.3.1 Chronic headache associated with pericranial muscle tension

A. The headache meets the criteria for 2.3 Chronic tension-type headache B. Increased tension of the pericranial muscles on palpation.

2.3.2. Chronic tension headaches not associated with pericranial muscle tension

A. The headache meets the criteria for 2.3 Chronic tension-type headache B. There is no tension in the pericranial muscles on palpation.

The identification of the above subtypes of TTH is associated not only with a superficial division depending on frequency, but primarily with differences in pathophysiology, the degree of impact on quality of life and different approaches to therapy. In the development of EGTH, peripheral pain mechanisms play a leading role. The chronic form of the disease is characterized by dysfunction of the central parts of nociception. Thus, it is pathophysiologically justified for EGTH to use only symptomatic drugs that relieve headache, while for frequent and CGTH, preventive therapy is required. This once again confirms the importance of correct diagnosis, consistent with ICHD-III, to determine the most effective and safe treatment strategy

note ! In clinical practice, it should be taken into account that, quite rarely, tension headaches can have a unilateral localization or a pulsating nature. According to a population-based study, a pulsatile component of tension-type headache was sometimes observed in 14% of patients. In 10% of cases, pain syndrome with tension-type headache had unilateral localization (