Tension headache: Dealing with this type of headache 

migraine causing allodynia

Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine

Little known, tension headache is one of the most common headaches these days. It affects irregularly and temporarily about 80% of the population. It can affect any individual of any age and any sex even if it predominates in people over 20 years old, in particular because of stress. 

Besides stress, are there other causes of tension headaches? What are the symptoms of this type of headache ? How to diagnose it and what to do to treat it? You will find all the necessary explanations in this article.

Definition: What is a tension headache?

La tension headache corresponds to a pain localized at the level of the skull and which sometimes extends towards the nape of the neck. Of mild or moderate intensity, it generally results in feelings of tension and both painful and embarrassing pressure.

When talking about a tension headache, the first idea that comes to mind is often related to blood pressure (like a high voltage). However, be aware that this is a completely false assumption.

According to professionals, this type of headache comes mainly from certain forms of mental (stress) and/or muscular tension (contraction of neck muscles).

Usually, tension headaches are not symptoms of other diseases, but appear on their own. This is why they are called primary headaches, such as migraines.

 Tension headache: pathophysiology

Until today, we still do not know the real mechanisms of tension headache development. Some hypotheses support the fact that it is related to migraine. The latter leads to the abuse of analgesics which often accentuates the appearance of tension headaches. Moreover, their mechanisms within the body are roughly similar. On the other hand, these hypotheses have no tangible scientific evidence.

Also, the link between the tension headache and contracture of the precranial muscles also has not been confirmed. They can have multiple causes.

What causes tension headache?

The tension headaches are mainly influenced by peripheral factors, namely:

The sleep disturbances and stress are also frequently associated with this type of headache.

La trough and l'anxiety, meanwhile, are factors of aggravation of symptoms. On the other hand, intense physical activities (sport), environmental disturbances such as light and noise do not aggravate the pain, but only cause irritability.

Certainly the causes of tension headache vary depending on the type of tension headache (explained below), more specifically according to the duration and frequency of the onset of symptoms.

How do symptoms of tension headache manifest?

La tension headache usually begins with pain in the front of the head, around the eyes, in the temporal and occipital regions. The pain then spreads gradually to be felt completely in the head. It is a pain that gives the effect of tightening and bilateral pressure at the level of the skull. In other words, we feel a vice feeling.

 The intensity of had de tete may vary depending on the case ranging from mild to moderate.

It lasts between 30 minutes to several days. Its frequency and duration which are also variable. They allow to distinguish 2 types of tension headache.

episodic tension headaches

They are also called muscle tension headaches ou stress headaches. Their frequency is less than 15 days. They last on average between thirty minutes and several days.

Chronic tension headaches

They have a frequency of more than 15 days each month. The pain felt is then chronic.

The origins of this chronic tensive headache may be different. They are probably dysfunctional: due to poor activity of the pain control system, for example. This is what happens in case of fibromyalgia.

Le temporomandibular joint dysfunction syndrome ou SADAM is also suspicious. It is characterized by pain related to jaw movements: opening the mouth, chewing. She is not a cause of tension headache. However, these two syndromes may be related. In this case, the tensive headache is secondary to contractures of the temporal and masseter muscles (muscle responsible for chewing).

There are also other headaches which are themselves associated with tension headaches. The pain resembles a mild migraine. On the other hand, nausea and vomiting are absent. They can occasionally cause anorexic disorders.

What are the consequences of tension headache?

The pain felt constitutes a constraint for the daily life of the patient. It causes hypersensitivity and a certain irritability. For example, the person is easily irritated by high light intensities (photophobia), sounds or noises (photophobia) or unpleasant smells.

Diagnosis of this headache

Diagnosis is very important. It avoids any confusion between the tension headaches and other headaches that could hide a more serious pathology. In other words, they make it possible to differentiate between a mild headache and symptomatic headache, some of which may be complicated neurological emergencies.

To establish the diagnosis, the doctor then begins with a clinical examination. He investigates the patient on the symptoms: their duration and their manifestations, the irradiations, the aggravating factors and the calming factors...

Then, for confirmation, he prescribes imaging tests such as MRI and CT scan. This can help to have more certainty on the result of the diagnosis and also makes it possible to rule out other pathologies. In this way, it would be easier to set up an adequate treatment.

How to treat tension headaches?

If in doubt about the existence of a tension headache, know that it is always wise to consult the opinion of a neurologist, to confirm the diagnosis and receive appropriate care.

Several types of treatment exist for treat and relieve tension headache.

In first intention, there are medical treatments by the administration of anti-analgesics or painkillers. This helps relieve the headache.

If you have a chronic tensive headache, it is possible to use migraine medication. For example, we can cite beta blockers, calcium channel blockers, monoamine blockers or antidepressants which have a more effective relieving effect.

Then, physical and mechanical treatments such as physiotherapy or massage therapy are also effective. Applying a light massage to the affected area can sometimes reduce the pain.

Finally, relaxation, meditation and relaxation allow relieve and prevent tension headache. Also, stress management is very important. A psychologist could, for example, give you advice on how to relieve your stress, learn to manage your daily tasks, be more active on a daily basis, etc.

References

https://www.deuxiemeavis.fr/pathologie/cephalees-de-tension

https://sfemc.fr/maux-de-tete/cephalee-de-tension.html

https://www.sciencedirect.com/science/article/abs/pii/S1878622712000665

https://www.msdmanuals.com/fr/accueil/troubles-du-cerveau, — de-la-moelle-%C3%A9pini%C3%A8re-et-des-nerfs/c%C3%A9phal%C3%A9es/c%C3%A9phal%C3%A9es-de-tension# : ~ : text=Les%20c%C3%A9phal%C3%A9es%20de%20tension%20sont%20d%C3%A9crites%20comme%20une%20sensation%20d, de%2015%20jours%20par%20mois.

https://www.qare.fr/sante/cephalees/tension/

https://www.doctissimo.fr/html/sante/encyclopedie/cephalee-tension.htm

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