Dull headache without throbbing is one of the clinical features of tension-type headache. Dull pain: the pain is slow, persistent, is a generalization of a variety of pain (such as swelling, tight pressure, etc.), most often seen in headaches caused by chronic diseases, is caused by insensitive pain-causing tissues. Tension-type headaches are the most common type of headache and are generally considered to be more prevalent than migraines, accounting for about half of outpatient headache patients. What causes tension-type headache? The pathophysiological mechanisms are unclear and may be related to a variety of factors, such as contraction or ischemia of muscle or myofascial structures, intracellular and extracellular potassium ion transport disorders, and chronic or intermittent dysfunction of CNS monoaminergic transmitters. Tension is not the primary cause and has been suggested to be related to persistent neck and scalp muscle contractions due to stress, tension, depression, etc., but may be a secondary phenomenon. The relationship between tension-type headache and pericranial muscle disorders has been discussed in the literature since 1940, but whether muscle disorders are a cause or a consequence of tension-type headache, or just one of the factors in the pathogenesis of TTH, is still inconclusive. Peterson et al. studied a group of patients with tension-type headaches regarding the specificity of the location of the painful muscles in the head that occur during their headaches. They used a self-graded rating method to detect pain and muscle tension in five muscles, including the frontal, temporal, chewing, head-clamping, and trapezius muscles, and looked at the level of electromyographic activity in these muscles. Although detailed quantitative observations were made for each muscle, the results did not reveal a significant relationship between the level of muscle pain and muscle tension and the level of electromyographic activity.Jensen et al. observed 28 cases of each of their subtypes, CTTH and ETTH, by means of quantification of tenderness, broad value of compression pain, threshold of thermal pain, and electromyographic activity of temporal and trapezius muscles, and found that, in the case of patients with CTTH accompanied by pericranial muscular disorders, tenderness was The results showed that in patients with CTTH with pericranial muscular disorders, their tenderness was significant, and they were hypersensitive to mechanical stimulation of pain, i.e., the more significant the tenderness was, the more sensitive they were to mechanical stimulation, and the electromyographic activity was also significantly increased. However, there was no abnormality in the threshold for thermal pain stimulation. In patients with ETTH, none of these changes were evident. In recent years Bansevicius et al. have also studied the correlation between muscle pain, tension and electromyographic responses in TTH patients. Experiments were conducted on pain using a visual analog scale to record the level of pain in the forehead, right and left temporal muscles, neck, and right and left shoulder muscles, and simultaneously tracing the superficial electromyographic activity of the area. Another questioning method was used for tension and fatigue, which was self-rated by the patients and also recorded according to the VAS method. The above quantitative study revealed that there was a significant correlation between fatigue and pain in all experimental procedures, and fatigue was like a part of headache, i.e., the longer the duration of headache, the more pronounced the feeling of fatigue; however, the correlation between tension and pain was weaker, and it was only found in the post-experimental period, and it was only found in the muscles of the neck. As for the correlation between EMG activity and pain, between EMG activity and fatigue, and between tension and fatigue, there was no correlation. The authors therefore concluded that tension does not play a prominent role in tension headaches.