Tension-type headache treatment

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. 

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. 

Ashina, M. Nitric oxide synthase inhibitors for the treatment of chronic tension-type headache, Exp. Op. Pharm. 2002, 3, 395-399. 

Sparano, Nicole. Is the Combination of Ibuprofen Plus Caffeine Effective for the Treatment of Tension-type Headache Journal of Family Practice 50 (January 2001) 312-319. 

Packman, B. Packman, E. Doyle, G. Cooper, S. Ashraf, E. Koronkiewicz, K. Jayawardena, S. Solubilized ibuprofen evaluation of onset, relief, and safety of a novel formulation in the treatment of episodic tension-type headache. Headache 2000, 40 (7), 561-567. 

Simple analgesics (alone or in combination with caffeine) and NSAIDs are effective for the acute treatment of mild to moderate tension-type headache. Acetaminophen, aspirin, ibuprofen, naproxen. 

Jensen R, Olesen J. Tension-type headache An update on mechanisms and treatment. Curr Opin Neurol 2000 13 285-289. 

ADP-ribosylation reactions such as DNA repair, calcium mobilization and deacetylation (Kirkland 2009). In addition, at pharmacological concentrations, niacin is an effective agent for the treatment of dislipidemias and atherosclerosis (Prousky et al. 2011). Furthermore, evidence exists that niacin ameliorates acute migraine, chronic tension-type headaches, depression and schizophrenia (Prousky et al. 2011). This chapter focuses on chemical and biochemical aspects of the vitamin. 

Currently, there is no specific abortive treatment for a tension-type headache (TTH). Self-medication constitutes the most common treatment. Among headache sufferers, 91% of TTH and 90% of migraine patients use non-opioid, over-the-counter analgesics, which are often taken without any other form of treatment and without consulting a physician. A community-based... 

Bigal ME, et al. Advances in the pharmacologic treatment of tension-type headache. CurrPain Headache Rep 2008 12 442-446. 

Aspirin and other salicylates are used in the treatment of mild to moderate pain. Aspirin is commonly used to treat headache (including migraine and tension type) and to decrease elevated body temperature. Salicylic acid, as a 10% to 20% solution in alcohol or propylene glycol, is used for the treatment of corns. 

The International Headache Society classifies headaches into one of 13 categories, ranging from migraine, tension-type, and cluster headaches, to headaches that are not classifiable. Effective headache treatment is thus guided by an accurate diagnosis of the headache type. 

This section covers oral non-prescription medicines for most types of pain, including tension headache, migraine, sinusitis, dental pain and musculoskeletal pain. Treatment for dysmenorrhoea pain is covered in Chapter 31. 

Other types of headaches, including migraines, often have elements of muscle tension and somatic dysfunction. Somatic dysfunction of the upper cervical spine causes pain behind the eyes. Migraine headaches are frequently associated with abnormal motions or restrictions of the temporal bones. Any patient with headache should be evaluated for somatic dysfunctions of the cranium and cervical spine with treatment of any found. 

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