Central and peripheral mechanisms in chronic tension-type headache
Gay L. LipchikKenneth A. HolroydChristopher FranceSteven A. KvaalDavid SegalGary E. CordingleyLori A. RokickiHeidi R. McCool
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Abstract:
The second exteroceptive suppression of masseter muscle activity (ES2) and tenderness in pericranial muscles were evaluated in 112 young adults who met IHS criteria in the following diagnostic classifications: 31 chronic tension headache, 31 episodic tension headache, 33 migraine without aura and 17 migraine with aura. An additional 31 subjects served as controls. Pericranial muscle tenderness better distinguished diagnostic subgroups and better distinguished recurrent headache sufferers from controls than did masseter ES2. Chronic tension headache sufferers exhibited the highest pericranial muscle tenderness, and controls exhibited the lowest tenderness (P < 0.01). All chronic tension headache sufferers exhibited muscle tenderness in at least one of the pericranial muscles evaluated, while tenderness was exhibited by 52% of controls. The association between pericranial muscle tenderness and chronic tension headache was independent of the intensity, frequency, or chronicity of headaches. Our findings raise the possibility that pericranial muscle tenderness is present early in the development of tension headache, while ES2 suppression only emerges later in the evolution of the disorder.Keywords:
Tension headache
Muscle tension
In an exploratory study of a general population of 209 young children (M = 12.9 yr. old), 59% of those with migraine or tension headache (n = 41) reported one or more triggers. More triggers were reported from those with tension headaches than from those with migrainous headaches.
Tension headache
Migraine Disorders
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The relationship between muscle activity and subjective pain in tension headache has been studied by comparing frontal EMG activity during and between headache episodes. Fifteen patients suffering from chronic tension headache were assessed during the course and outside headache episodes. These results suggest that there is no direct and constant relationship between muscle tension and pain in tension headache.
Tension headache
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Tension headache
Complaint
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The second exteroceptive suppression of masseter muscle activity (ES2) and tenderness in pericranial muscles were evaluated in 112 young adults who met IHS criteria in the following diagnostic classifications: 31 chronic tension headache, 31 episodic tension headache, 33 migraine without aura and 17 migraine with aura. An additional 31 subjects served as controls. Pericranial muscle tenderness better distinguished diagnostic subgroups and better distinguished recurrent headache sufferers from controls than did masseter ES2. Chronic tension headache sufferers exhibited the highest pericranial muscle tenderness, and controls exhibited the lowest tenderness (P < 0.01). All chronic tension headache sufferers exhibited muscle tenderness in at least one of the pericranial muscles evaluated, while tenderness was exhibited by 52% of controls. The association between pericranial muscle tenderness and chronic tension headache was independent of the intensity, frequency, or chronicity of headaches. Our findings raise the possibility that pericranial muscle tenderness is present early in the development of tension headache, while ES2 suppression only emerges later in the evolution of the disorder.
Tension headache
Muscle tension
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Forty patients with tension headache and 40 healthy comparable control persons were palpated by the same "blinded" observer. Tenderness in 10 pericranial muscles on each side was rated on a four-point scale. A Total Tenderness Score was calculated for each individual by adding the scores from all palpated areas. Headache patients had significantly higher scores than controls and also significantly higher tenderness in each point separately. Median normal values and confidence limits for tenderness are given. Among 23 patients with daily headache a correlation was found between headache intensity and Total Tenderness Score. It is likely that the pathologic tenderness in patients with tension headache is the source of nociception, but pain mechanisms are more complex, as evidenced by discrepancy between tenderness and pain in some patients. Pathologic tenderness should be a contributing criterion to the diagnosis of tension headache (muscle contraction headache).
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Phantosmia is a rare migraine aura. We present two cases of phantosmias occurring before migraine headaches and also without headaches. To our knowledge, these are the third and fourth cases of phantosmias ever reported due to migraine aura without headache.
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SYNOPSIS Exertional headaches in patients with Arnold‐Chiari malformation (ACM) are well described. Were port four patients with Type I ACM and recurrent headaches. These patients presented, respectively, with low spinal fluid pressure headache, migraine without aura, migraine with aura, and migraine with prolonged aura. This report suggests the need for observing patients with recurrent headaches for any physical stigmata of craniovertebral junction anomalies, and the need to exclude ACM in such patients. Possible implications of the association between ACM and different types of headaches are discussed.
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The effects of music therapy in conjunction with chiropractic management of muscle tension headaches
This study proposes to evaluate the combined effects of music therapy and chiropractic treatment in the management of muscle tension headaches, in terms of the patients' response, in order to establish the efficacy of music therapy as an adjunct to chiropractic management of muscle tension headaches. It was hypothesized that music therapy and chiropractic treatment combined have a more beneficial effect, in that it would reduce muscle tension headaches to a greater extent than chiropractic treatment alone, thus reducing the severity, duration and frequency of muscle tension headaches. The diagnostic criteria for muscle tension headache were consistent amongst the majority of authors. The most common cause was attributed to psychological or occupational stress on the posterior neck musculature i .e. an increase in muscle tension. An increase in muscle tension in muscle tension headache sufferers measured with an electromyogram was reported on by various authors. A decrease in electromyogram readings in response to music therapy has also been measured. Certain authors have attributed muscle tension headaches to cervical facet joint dysfunction. The presence of myofascial trigger points occurring concurrently with a muscle tension headache was mentioned. The majority of authors were in agreement as to the most beneficial type of music to be used. The music is to have a
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muscle spasm
Tension headache
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SYNOPSIS This study compared physiological reactivity to stress of subjects who frequently experience tension headaches and subjects who rarely get headaches. Physiological measures were Frontal and Trapezius muscle tension and Heart Rate. Subjects prone to headaches and subjects not prone to headaches did not differ on any variable, although there was a trend for subjects who were prone to headaches to have the highest Frontal muscle tension levels. For further analyses, subjects prone to headaches were separated into two groups: Subjects with headache during the psychophysiological assessment and subjects who were headache‐free during the assessment. Only subjects who were prone to tension headaches and who were actually experiencing a headache at the assessment had significantly higher Frontal muscle tension than controls who were not prone to headaches. These results suggest greater attention needs to be paid to the subjects' current headache state in research on the psychophysiology of headache.
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Muscle tension
Psychophysiology
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