Tension headache a feeling of tightness, pressure or dull pain in the head, more typically with a girdling sensation. As a transient disorder, tension headaches are mostly associated with stress in daily life, but if they persist, they may be one of the characteristic symptoms of anxiety or depression.
Tension headaches are caused by persistent contractions of the muscles of the head and neck, and there are three causes of such contractions.
(1) As a result of anxiety or depression accompanied by mental tension;
(2) As a secondary symptom of other causes of headache or pain in other parts of the body;
(3) as a result of poor posture of the head, neck and scapular girdle. The disease is extremely common clinically, mostly in women, and mostly develops around the age of 30, and psychotherapy can often receive good results.
The main causes of tension headache are mental tension caused by heavy study and work pressure, emotional abnormalities and severe lack of sleep, which cause abnormal blood supply to the brain vessels of the body and cause cerebral vascular spasm, thus leading to headache. The pain is usually symmetrical, extending from the back of the head to the forehead, and the headache lasts for about several hours. During the illness, the headache attacks daily, and usually the patient does not notice that the headache is related to mental tension, but when carefully inquired, it is not difficult to find the direct relationship between the patient’s tension and the headache. An Australian medical authority, Dr J. Murtagh, wrote in 1994 that in addition to psychological factors, malfunction of the cervical spine is also a major cause of tension headaches.
Clinical manifestations
1. The headache is usually located in the forehead, occipital and cervical regions, with a persistent dull pain, and the patient often complains of a feeling of tightness and pressure on the head, without nausea or vomiting;
2.The headache may appear in the morning when waking up or soon after waking up, and may gradually worsen or remain unchanged all day;
3.Some patients have migraine headache;
4.Some patients have “empty pillow” sign.
Examination
1.Electromyography, electroencephalogram.
2.Special examination of ophthalmology.
3.X-ray examination, MRI examination, CT examination.
Diagnosis
1.Headache mostly occurs around 30 years old, mostly located in the two foreheads and occipital and neck areas, with persistent dull pain, and the persistence of headache is its main feature;
2.Some patients have migraine and migraine together;
3.Some patients have “empty pillow” sign;
4.Exclude headache caused by brain tumor, hypertension, epilepsy and glaucoma.
Tension headache can be classified into the following categories.
1. Episodic tension headache.
1) Episodic tension headache related to pericranial muscle disorders;
② Episodic tension headache not related to pericranial muscle disorders.
2.Chronic tension headache.
(1) Chronic tension headache related to pericranial muscle disorders;
② Chronic tension headache not related to pericranial muscle disorders.
3.Tension headache that does not meet the above criteria.
Treatment
The key to this disease is to prevent attacks, and psychological examination and psychotherapy are extremely important, which should be supplemented with limited medication on the basis of psychotherapy.
Treatment principles
1.Seizure period: control the headache.
2.Relief period: prevent attacks.
Combined treatment of Chinese and Western medicine is effective.