Tension-type headaches, stress headaches
Tension-type, stress, contracture headaches are part of psychogenic primary headaches, although a number of recent studies are in favor of a neurological basis – at least for the most severe types of tension-type headaches.
Are the most common type of headaches, with a prevalence of 30-78% in the general population. It is more common in women and is associated with anxious-depressive states. At the same time, it is the least studied of the primary headaches, despite the fact that has the highest socio-economic impact.
The headaches start gradually and not suddenly and don’t have a pulsatile nature, are continuous – day and night.
As a rule, are bilateral, as a band around the head like a pressure in frontal, occipital, temporal areas and / or vertex.
Tension-type headaches can be episodic or chronic, permanent (weeks or years). Chronic type reduces the patient’s quality of life, causing inability to work.
In turn, episodic form is divided into type rare (less than one episode of headache per month), and the common subtype (appears professional failure and the need for prophylactic medications).
Both episodic and chronic tension headaches can be with or without sensitivity around the head. This translates into sensitivity or pain at palpation of neck or shoulder muscles (occurs due to muscle contraction).
There are no specific investigations and analyzes and are used to exclude other types of headaches. Psychiatric examination is part of the diagnostic algorithm.
Treatment of tension-type headaches
Abortive treatment of the crisis can be done with:
1. NSAIDs – aspirin, paracetamol, ibuprofen, indomethacin;
2. Drug combinations – Cofedol. In all forms showing contracture around the head it may be used muscle relaxants – Tolperison.
It will be performed when the patient has more than 15 headache attacks per month or if the intensity is causing disability. It will use the same drugs as prophylactic treatment of migraine (eg tricyclic antidepressants).