Possible Mechanisms and Treatment of Analgesic-Induced Chronic Headache

Abstract

Chronic muscle contraction headache is characterized by constant dull pain of at least 1 year’s duration. The pain may be generalized, unilateral, vise-like, frontal or frontotemporal (Friedman et al. 1954; Lance and Curran 1964). It is often described as a nonthrobbing, pressure-type discomfort, waxing and waning throughout the day, every day, from morning until sleep. Most interesting is the frequency of analgesic use in this condition. We found that the mean daily intake of analgesic tablets consumed by 200 patients with chronic muscle contraction headaches (CMCH) was 6.2. Only 28% of patients used only simple analgesics; 38% used analgesics compounded with sedatives, tranquilizers or muscle relaxants; 31% used narcotics; and 24% used narcotic antagonists. In 36% of cases more than one type of preparation was used. Most curious was the admission of most patients that, in spite of the frequent use of analgesics, little relief was obtained (Kudrow 1982).