Tension-type headache ( TTH ) - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Nerve Disease

Tension-type headache (TTH) - the most common headache.

Monotonous, compressing, squeezing, tightening, dull, diffuse, double-sided, "as the hoop pulled together", "like wearing a helmet", "in the grip of" mild to moderate, accompanied by irritability, nervousness, fatigue, weakness, fatigue, violationsleep and appetite, increased sensitivity to sudden noises and bright light - it's "compliments" about it - tension headaches.Tension headaches are subject to all ages of the population, even children, more often affects women.

Reasons head

tension headaches tension-type headache develops in mental strain as a result of chronic stress and as a result of prolonged muscle tension.Muscle tension often associated with professional posture - prolonged periods of sitting at the computer, driving a car, work related to long eyestrain, for example, with small details (seamstresses, watchmakers, jewelers, collectors electronic equipment ...), constant observation of video monitors.Inconvenient posture during sl

eep may also be a cause of tension headaches.In the mechanism of tension-type headache is set tension of the neck muscles, eye muscles, the muscles of scalp fascia - the so-called "muscle stress."

Long-term use of analgesics and tranquilizers contributes to the development of chronic headache.In real life, often these factors are combined.

Strengthening headaches can be triggered by emotional stress, change of weather, strong wind, starvation, work in a stuffy room, mental and physical fatigue, night work, improper posture while sitting, alcohol intake.

in the pathogenesis of tension-type headache have a role:

- tonic spasm of the muscles, as a starter unit ischemia, edema, electrolyte and biochemical changes that lead to spasm of blood vessels and increases the pain,
- disorders in the central mechanism of chronic pain - reduced pain threshold,lack of serotonergic systems, lack of antinociceptive system function,
- depression.

«Pain behavior" - behavioral reactions of the patient on chronic pain - violate the body's adaptation processes and exacerbate the pain.There are neurons with increased excitability and lack of braking mechanism in the brain structures, in which the processing of nociceptive (pain) information (the frontal and temporal lobes, their mediobasal part and the limbic system).

in chronic tension-type headache development matters malfunction antinociceptive system and psychosocial maladjustment as a consequence of behavior, personality, emotional reactions to the level of neurotransmitter mechanisms.

nociceptive system - a neuroendocrine analgesic mechanism.By reducing the threshold of pain receptors usual stimuli are perceived as painful.Perhaps the perception of pain without pathological impulses from the sensing receptors, and by the emergence of foci of excited neurons - "enhanced pathological excitation generators" in the brain.Dysfunction antinociceptive system is expressed in the reduction of the descending inhibitory effect on neurons that receive and conducting nociceptive sensory streams.Thus it disturbed as a perception of pain, and its implementation, the processing and the response to it - its inhibition.

main mediators analgesic system:

- opiate neuropeptides - enkephalins and endorphins have chemical similarities to narcotic analgesics,

- biogenic amines produced by the serotonergic and noradrenergic neurons - affect the perception of pain similar to tricyclic antidepressants.

It turns out that the body itself produces painkillers.In the pathology of this mechanism is broken or do not work.If emotional stress, fatigue, psychopathological states reduced pain control at all levels of processing of pain impulses.Weak signals from a strained muscle pain perceived inadequately.Occurrence hyperactive neurons leads to chronic pain.Depression exacerbates these disorders at the level of neurotransmitter biochemical processes and supports pain.

Symptoms headache

voltage Distinguish tension headache dysfunction perikranialnyh muscles and without such a combination.

Depending on the duration and frequency of headaches are classified - episodic and chronic tension-type headache.
Headache lasting from 30 minutes to 7 days for two weeks, a month, six months a year - episodic headache.It is more common - 80% of all types of headache.
Headache lasting longer than 2 weeks during the month, and more than six months during the year - a chronic headache.

Episodic headache usually less intense, often accompanied by anxiety disorders, it occurs after the triggering moments - long visual or mental stress, uncomfortable postures.Chronic headache - almost daily, do not stop, monotonous, it does not change from the stress, intense, accompanied by the development of depression, demonstrative, paranoid personality changes, impaired social activity.

Tension-type headache is not accompanied by nausea and vomiting, is not attacks, it has a pulsating character.

When the headaches should see a doctor - the family, therapist, neurologist.

Obsdeovanie at the head

tension headaches On examination revealed increased tension and soreness of the trapezius muscle, neck muscle paravertebral points of the cervical and thoracic spine, and no focal neurological symptoms.If the tension headache is not accompanied by muscle soreness perikranialnyh, it is considered as psychogenic.Quite often, tension headache is accompanied by psychopathological disorders - anxiety, depression, premenstrual tension, asthenia, psycho-vegetative disorders - fluctuations in blood pressure, tachycardia, shortness of breath, panic attacks.

Initial comprehensive examination is necessary to exclude organic brain damage.They can be assigned to a computer and magnetic resonance imaging, X-ray or cervical spine imaging, electroencephalography (with fainting), Doppler main arteries, inspections ophthalmologist, internist, otolaryngologist, laboratory diagnostics - complete blood count, blood sugar, biochemical analyzes (here individuallydepending on the physical variances detected).The results of psychological testing contribute to the selection of adequate means of therapy for a particular patient.

Differential diagnosis:

- diagnosis of the type of headache,
- organic neurological disease,
- somatic diseases in which the headache - one of the symptoms.

Treating tension headaches

Treatment of tension-type headache is aimed at psihalgichesky, myofascial and cervicogenic factor.Used in the treatment of pharmacological and non-pharmacological methods of influence.

For relief of headache is recommended to use a head massage and a cervical collar zone, post-isometric relaxation, acupressure, acupuncture, analgesics short reception.Good results in the treatment of chronic headache provides cognitive-behavioral therapy.

Massage with tension headaches


Most headaches are using acetaminophen, non-steroidal anti-inflammatory drugs (ibuprofen) and a combination of drugs with codeine, phenobarbital, caffeine, possibly in combination withtranquilizers.It is important to remember that the prolonged use of analgesics and tranquilizers abuzusnoy lead to headaches.

Prevention headache

To prevent headaches is recommended to optimize the mode of the day, the conditions of work and leisure, employment physical therapy, water therapy, the implementation of individual recommendations vertebral neurology, neurologist and psychotherapist, physiotherapy, psychotherapy, aromatherapy, chiropractic, spa treatment.From the pharmacological drugs used muscle relaxants (sirdalud, Mydocalmum) and antidepressants.Treatment is individually!Antidepressants are prescribed by a doctor because of possible side effects and the need for long-term use - at least 6 months, with a gradual increase and subsequent decrease in dose.

analgesic effect of antidepressants is that, firstly, the effect is achieved through the weakening of depression;Second, they enhance the action of both exogenous and endogenous analgesic substances;- third, antidepressants activate descending antinociceptive system.Even the analgesic effect occurs at lower doses, and faster than the antidepressant.

When asthenia used nootropics, vitamins, magnesium preparations.

Correct posture during sedentary work .

Doctor's consultation on tension headache:

Question : what is the rebound headache?
answer : prolonged or frequent dosing of analgesics, tranquilizers (up to 15 days per month for 3 months) develops addictive, and painkillers cause headaches themselves.She called abuzusnoy.Therefore it is impossible uncontrolled and often long-term pain medication.«To abuse» - abuse.

neurologist Kobzev SV