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Yogi’s Headache: Chronic Tension-Type Headache

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Chronic Headache

Abstract

Tension-type headache (TTH) is the second most common condition worldwide (surpassed only by dental carries). As seen in migraine, TTH may progress to a chronic state. It is estimated that the incidence for chronic tension-type headache (CTTH) in the USA is 2.2%. Pericranial muscle tenderness is the most common finding in both episodic (ETTH) and CTTTH. The increased nociceptive CNS input from the cephalic and extracephalic musculature initiates a “feedback loop” that may lead to central sensitization by increasing the attention and emotional response to pain. Active and passive trigger points are frequently present in TTH. The presence of active trigger points has been shown to have a role in CTTH progression. As seen in other chronic pain states, in CTTH central mechanism of hyperexcitability and impaired inhibitory response have a role in pathogenesis.

Tension-type headache comorbidities include insomnia, depression, neck pain, and temporomandibular joint disorder. Insomnia is especially associated to CTTH chronification. Treatments for ETTH appear to be more effective than for CTTH. The treatments outlined here involve pharmacological, behavioral, physical, and procedural interventions.

Tension-type headache remains an underdiagnosed and undertreated entity with poorly understood pathophysiology. However, the burden of tension-type headache both individually and societally is significant, and its association with stress suggested tension-type headache may be a marker for a variety of social and personal circumstances that require attention.

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Notes

  1. 1.

    As measured on the Medical Outcomes Study SF-36

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Authors and Affiliations

  1. Central Texas Headache Fellowship, Headache Medicine, Baylor Scott and White, Temple, TX, USA

    Duren Michel Ready, Linda Kirby Keyser & Cristina Cabret-Aymat

  2. Neurology, Presbyterian Hospital, Rio Rancho, NM, USA

    Weiwei Dai

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  2. Weiwei Dai
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  1. Department of Headache and Pain Medicine, Icahn School of Medicine at Mt. Sinai, Department of Headache and Pain Medicine, New York, NY, USA

    Mark W. Green

  2. Neurology & Neurological Sciences, Stanford School of Medicine Neurology & Neurological Sciences, Stanford, CA, USA

    Robert Cowan

  3. Department of Neurology, Medical College of Wisconsin, Department of Neurology, Milwaukee, WI, USA

    Frederick G. Freitag

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Ready, D.M., Dai, W., Keyser, L.K., Cabret-Aymat, C. (2019). Yogi’s Headache: Chronic Tension-Type Headache. In: Green, M., Cowan, R., Freitag, F. (eds) Chronic Headache. Springer, Cham. https://doi.org/10.1007/978-3-319-91491-6_5

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  • DOI: https://doi.org/10.1007/978-3-319-91491-6_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-91490-9

  • Online ISBN: 978-3-319-91491-6

  • eBook Packages: MedicineMedicine (R0)

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