Headache tension

Acetaminophen is commonly used for relief of fever and headaches and is a major ingredient in numerous cold and flu remedies. It is also used in multi-ingredient preparations for migraine headache, tension headache, and vascular headaches. 

Prevalence rates for a variety of different types of pain have been described. The annual incidence of moderate-intensity back pain is 10% to 15% in the adult population with a point prevalence of 15% to 30%.3 Migraine affects more than 25 million Americans, and 90% of Americans report some other types of headaches (e.g., tension or sinus) each year.4 Pain resulting from fibromyalgia affects 4 million Americans.5 Cancer is commonly associated with both acute and chronic pain, and about 70% of those diagnosed with cancer will experience significant pain.6... 

Primary headaches are classified as migraine, tension-type, or cluster and other trigeminal autonomic cephalalgias. 

Tension-type headache (TTH) is the most common primary headache disorder. It is often underrepresented in clinical practice, as many patients do not present for care.6 The term tension-type headache is used to describe all headache syndromes in which muscle contraction is the most significant factor in the pathogenesis of pain. The 1-year prevalence of TTH in the population ranges from 30% to 90%.6 It is more common in adult females. Environmental factors, as opposed to genetic predisposition, play a more central role in their development. Tension-type headaches can be further divided into episodic or chronic the mean frequency of attacks is 3 days per month in episodic disorders, and chronic TTH is defined as 15 or more attacks in a 1-month period.7 The estimated prevalence of chronic TTH is less than 5%.6 Some researchers believe that chronic TTHs represent a continuum of headache severity with migraine headache.8 When severe headaches are difficult to differentiate clinically, treatment should initially target TTH. 

Clinical Presentation and Diagnosis of Tension-Type Headache ... 

Patients experiencing tension-type headache may display the following headache symptoms and characteristics ... 

Ruoff G, Urban G. Treatment of primary headache episodic tension-type headache. In Standards of care for headache diagnosis and treatment. Chicago National Headache Foundation, 2004 53-58. 

The major clinical study underpinning product approval was a randomized, double blind study in which 71 CTCL patients were administered the product at one of two dosage levels (9 or 18 [tg kg 1 day ) overall, 30 per cent of patients experienced an objective tumour response. Serious side effects potentially associated with product administration include acute hypersensitivity-type reactions, vascular leak syndrome and visual impairment. Additional adverse reactions include flu-like symptoms, headache, hyper- or hypo-tension, as well as digestive upset. Ontak is manufactured by Seragen Inc. and is distributed by Ligand Pharmaceuticals. 

For tension headaches during pregnancy, nonpharmacologic approaches are first-line therapies, including exercise, biofeedback, and massage. If drug therapy is needed, acetaminophen is the first choice. 

Headache Migraine and Tension-Type CHAPTER 53 LABORATORY TESTS ... 

Tension-type headache is the most common type of primary headache and is more common in women than men. Pain is usually mild to moderate and nonpulsatile. Episodic headaches may become chronic. 

Pain is thought to originate from myofascial factors and peripheral sensitization of nociceptors. Central mechanisms are also involved. Mental stress, nonphysiologic motor stress, a local myofascial release of irritants, or a combination of these may be the initiating stimulus. In predisposed individuals, chronic, tension-type headache can evolve. 

Acute medication for episodic headache should be taken no more often than 2 days/wk to prevent development of chronic tension-type headache. 

There is no evidence to support the efficacy of muscle relaxants for tension-type headache. 

The TCAs are used most often for prophylaxis of tension headache. Injection of botulinum toxin into pericranial muscles has demonstrated efficacy in prophylaxis of chronic tension-type headache in two studies. 

Neuropathic and functional pain is often described in terms of chronic pain. Neuropathic pain (e.g., postherpetic neuralgia, diabetic neuropathy) is a result of nerve damage, but functional pain (e.g., fibromyalgia, irritable bowel syndrome, tension-type headache) refers to abnormal operation of the nervous system. Pain circuits may rewire themselves and produce spontaneous nerve stimulation. 

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