Tension headache is the most common type of headache.
In the past, it was called muscle contraction headache, stress headache, psychogenic headache.
Unlike migraine, it is throbbing. It is generally defined as a feeling of pressure, a feeling of squeezing, a feeling of fullness in the head, a feeling of heaviness in the head and neck, or a feeling of being squeezed in a vice.
It is usually bilateral. It may occur in the forehead, back of the head and nape area, or it may occur all over the head at the same time.
It is not accompanied by nausea and vomiting, as in migraine, and it does not increase with physical activity.
The pain does not last a short time. It can last for days (may vary between 30 minutes and 7 days).
It does not usually prevent you from doing daily activities.
It gets a little worse, especially in the afternoon and evening.
Stress. Factors such as stress, fatigue, noise, insomnia, hunger, menstruation may trigger or aggravate tension-type headache.
Again, some patients with tension-type headache may experience problems with the jaw joint and neck pain.
Some patients with tension-type headache may experience problems with the jaw joint and neck pain. p>
It usually starts in the twenties. While it is more common in middle age, its incidence decreases with age. It is more common in women than in men.
Patients who experience tension headaches generally do not consult a physician if their headache frequency is low and they try to find a solution by resorting to painkillers.
However, patients who experience tension headaches frequently (1 to 15 days a month) Patients or patients with tension ligament pain that has become chronic (more than 15 days a month in the last 3 months) consult a physician because their daily lives are negatively affected.
In the examination of patients with tension headache, the forehead, temples, jaw, neck and shoulder are examined. Sensitive trigger points can be detected in the muscles. When moderate pressure is applied manually to the tense trigger points detected in these muscles, it can be determined that the sensitivity spreads with a feeling like electricity and is reflected to another area.
These trigger points cause the release of some inflammatory substances that increase pain and sensitivity. This occurs around the head. It causes the nerve endings in the muscles to become sensitive and stimulate, causing more frequent headaches.
In other words, head, jaw, neck Headaches of individuals with tension headaches, who have sensitive trigger points in the neck and shoulder muscles, may become more frequent or chronic.
Therefore, identifying trigger points in individuals experiencing tension headaches and eliminating these points with invasive methods is very important for treatment.
Also, it should not be forgotten that jaw joint problems, dental problems and teeth clenching problems are common in patients with tension headaches and increase the frequency of headaches.
Especially in patients with sleep apnea and hypertension, headaches that occur in the morning hours. Their pain may mimic tension-type headaches.
For this reason, regular blood pressure measurements should be followed to monitor whether there is hypertension, and it should be questioned whether there are any complaints that may suggest sleep apnea, such as snoring during sleep, shortness of breath during sleep, and excessive daytime sleepiness.
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The presence of psychiatric problems such as anxiety disorders and depression is also common in patients with tension headaches. Therefore, psychiatric evaluation, even if brief, is very important in planning the treatment in patients with tension headaches.
Apart from all these conditions, 'fibromyalgia' is also quite common, especially in patients with chronic tension-type headaches. Fibromyalgia is a chronic disease that is often seen in women and causes widespread muscle pain and tenderness throughout the body. Individuals experiencing fibromyalgia may experience symptoms such as sleep disorders, fatigue, anxiety, depression, forgetfulness, morning stiffness, widespread body aches and numbness, as well as headache.
As a result, many diseases are caused by tension. It may occur with a headache similar to a type headache.
For this reason, even if a person's headache has the characteristics of a tension-type headache, if there are suspicious circumstances in the patient's history, examination, and pain characteristics, brain imaging methods and It may be necessary to seek further examination.
What Triggers Tension Headache?
Just like migraine headache, tension headache can also occur. It has triggers.
Stress, psychological problems, depressive and anxious mood, insomnia Factors such as sleeping too much, excessive caffeine intake, irregular nutrition, heavy exercise, dehydration or low fluid intake, menstrual period and menstrual irregularities, and excessive intake of painkillers can be counted among the triggers.
Whether it is tension type or not. Frequent use of painkillers (more than 10 times a month for triptans and combined painkillers, more than 15 times a month for simple painkillers), whether for headaches or migraine-type headaches, can make the headache chronic, daily and chronic.
Staying away from triggers and excessive use of painkillers often prevents tension-type headaches.
Conversely, the frequency of tension headaches gradually increases and may cause the headache to become chronic.
>Apart from the triggers we have mentioned, it should not be forgotten that disorders such as snoring and obesity may also cause tension headaches to become chronic.
TREATMENT
Treatment for tension-type headache can be roughly divided into two: drug treatments and non-drug treatment methods. Drug treatments can also be divided into treatments that relieve acute attacks and preventive treatments.
1.Acute Attack Treatments
During headache attacks. It is used to overcome pain attacks. Simple painkillers, which we all know and use frequently for many reasons in daily life, are frequently used for this purpose.
Triptan group drugs and muscle relaxants used in migraine treatment have the ability to treat tension-type headache attacks. There is no.
Which painkiller will be used in which patient, in which dose and frequency will vary from person to person. In addition, unconscious and frequent use of painkillers may damage other organs due to their side effects, and after a while, the headache may become chronic and daily! For this reason, you should not use painkillers indiscriminately without a doctor's opinion.
2. Preventive Treatments
If headaches begin to occur frequently or seriously affect social life, preventive treatments should be considered.
The purpose of preventive treatment is to reduce the frequency of headache attacks, its severity and to reduce its duration. In addition, using timely, correct preventive treatments, for sufficient duration and dosage, will prevent the headache from becoming chronic and overuse of painkillers.
Which preventive treatment should be applied to which patient, in which dosage and duration, in case of headache. Since it varies from person to person, preventive treatment must be started by a physician.
In preventive treatment, antidepressants, centrally acting muscle relaxants, tranquilizers, some anticonvulsant drugs and melatonin can be used.
3.Non-Drug Treatments
Lifestyle changes, application of some techniques that can control the disease, as well as some effective and reliable treatments that can be preferred in patients who are resistant to or cannot tolerate drug treatments. are treatment options.
We can roughly list these methods as follows.
A.b.Regulating lifestyle and raising awareness about the disease
- Regular sleep and nutrition
- Exercise
- Relaxation exercises
- Posture regulation
B. Awareness and avoidance of triggers
C. EMG-Biofeedback
D. Cognitive-behavioral treatments (CBT) Psychological support, relieving anxiety
E. Physical therapy
F. Dry Needle Treatment
G. Trigger point injections
H. TENS (transcutaneous electrical nerve stimulation)
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