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Tension-type headache (TTH) imposes a heavy burden on the global population but remains incompletely understood and poorly managed.
A mild to
moderate constant band-like pain, tightness, or pressure around the forehead or
back of the head and neck may be called as an episodic tension headache. In
this study, muscle role has been explained well. It has put light on the
current drugs used and has paved the way for new ones in the future.
Tension-type
headache (TTH) imposes a heavy burden on the global population but remains
incompletely understood and poorly managed.
Here, we review
current knowledge of peripheral factors involved in the mechanism of TTH and
make recommendations for the treatment of episodic TTH based on these.
Peripheral
activation or sensitization of myofascial nociceptors is most probably involved
in the development of muscle pain and the acute episode of TTH. Repetitive
episodes of muscle pain may sensitize the central nervous system resulting in
progression of TTH to the chronic form. Thus, muscular factors may be
responsible not only for the acute headache episode but also for chronification
of the disorder. Simple analgesics and non-steroidal anti-inflammatory drugs
are the mainstays of management of individual headache episodes. Ibuprofen 400
mg and aspirin 1000 mg are recommended as drugs of first choice based on
treatment effect, safety profile and costs. Non-pharmacological therapies
include electromyographic biofeedback, physiotherapy and muscle relaxation
therapy. Future studies should aim to identify the triggers of peripheral
nociception and how to avoid peripheral and central sensitization. There is a
need for more effective, faster acting drugs for acute TTH.
Muscular factors
play an important role in episodic TTH. Ibuprofen 400 mg and aspirin 1000 mg
are recommended as drugs of first choice.
Eur J Pain. 2016 Feb;20(2):166-75
Muscles and their role in episodic tension-type headache: implications for treatment
L. Bendtsen et al.
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