Possible Mechanisms and Treatment of Analgesic-Induced Chronic Headache
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).
KeywordsMigraine Stim Amitriptyline
Unable to display preview. Download preview PDF.
- Friedman AP, von Storch TUC, Merritt HH (1954) Migraine and tension headaches. A clinical study of two thousand cases. Neurology 4: 773–788Google Scholar
- Holland JV, Holland CV, Kudrow L (1983) Low-dose amitriptyline prophylaxis in chronic scalp muscle contraction headache. Proc 1st International Headache Congress, Munich, p 134Google Scholar
- Kudrow L (1982) Paradoxical effects of frequent analgesic use. In: Critchley M, Friedman A, Gorini S, Sicuteri F (eds) Advances in neurology, vol 33. Raven, New York, pp 335–451Google Scholar
- Lance JW, Curran DA, Anthony M (1965) Investigations into the mechanism and treatment of chronic headache. Med J Aust 2: 909–916Google Scholar