Tension headache
Tension headache (GBN) is a type of pain in the area of the cranium, in which the patient experiences a mild feeling of compression. Most people describe the signs of this condition as a dull pain on both sides of the head, the intensity of which is low. Along with it, constant fatigue, nervousness, irritability, lack of proper sleep and appetite, hypersensitivity to bright light and loud high-pitched sounds can manifest themselves.
The content of the article:
Classification of tension headache
Etiology and pathogenesis of tension headache
Clinical picture of tension headache
Diagnosis of tension headache
Treatment of tension headache
Tension headache
According to statistics, tension—induced headaches are most susceptible to people aged 25-35 years, most of whom are women. Despite this, pain in the head area occurs in the elderly, and even in young children, if this episode was preceded by tension, mental or physical exertion.
Classification of tension headache
Tension-induced headache is divided into two types: episodic and chronic pain. The classification is based on the duration of the syndrome.
Episodic pain is unstable, its intensity is low. A person experiences discomfort associated with it for no more than 20 days a month or 180 days a year, that is, more than half of the time he feels satisfactory, but if he experiences some tension, he feels unwell.
Chronic pain is more prolonged — the patient experiences it for the specified periods and longer. The intensity of chronic pain is higher, and along with the headache, the patient often experiences prolonged depression.
Even taking into account the fact that the differences in the types of headache experienced due to tension are quite conditional, this classification helps the specialist to understand the general picture of the patient’s condition and make the correct diagnosis.
Etiology and pathogenesis of tension headache
The cause of GBN, as its full name says, is excessive tension: frequent stress, load on muscle tissue. The latter, as a rule, is a professional symptom that bothers everyone whose work is associated with a constant stay at the computer, driving or at a table with small details that require constant eye contact. At risk are office employees, seamstresses, truckers, jewelers, equipment assemblers, etc.
During the stay at the workplace, people working in a sitting position, the same muscle undergoes prolonged tension, which is the cause of headache. The development of GBN is provoked by a constant load on the cervical, ocular muscles and the muscles of the scalp aponeurosis.
In addition to these reasons, the causative agent of headache may be the following factors:
Long-term use of drugs-analgesics or tranquilizers;
Changing weather, especially wind direction;
Insufficient nutrition, starvation;
Being in a stuffy room;
Overwork;
Working at night;
Alcohol intake;
Incorrect posture.
In the pathogenesis of tension-induced headache, tonic spasm of muscle tissue is of key importance, causing ischemic processes and edema, which cause spasm, which increases pain.
It is impossible not to take into account such a factor as the insufficiency of serotonergic systems and the functions of the antinociceptive system, painful behavior that aggravates unpleasant sensations.
Pathologies of the antinociceptive system, which is a neuroendocrine analgesic mechanism, are often to blame for the development of a chronic type of headache. There are also many cases diagnosed when pain is observed in people with psychosocial maladaptation.
Clinical picture of tension headache
The main symptom of tension headache is discomfort in the head area. It feels like the head can be squeezed, which the patient gets used to quite quickly. He continues to do his usual job and live a full life. The duration of the period of such unpleasant sensations ranges from 30 minutes to several days, depending on the opportunity to relax and the individual characteristics of the body.
Often patients complain of a feeling of painful pressure from both sides of the head and pain passing from the frontal lobe to the occipital. Such pain, unlike its other types, has the same intensity and does not differ in pulsation, does not cause nausea and vomiting attacks. Concomitant symptoms of bilateral headache are hypersensitivity to bright light, intolerance to loud sound, a feeling of constant fatigue and irritability.
Since GBN is observed in people of all age categories, when making a diagnosis, specialists pay little attention to the age of the examined patient, primarily identifying the factors that provoked this condition.
Diagnosis of tension headache
There are no special examinations to diagnose tension pain. The diagnosis is made based on the words of the patient and the results of a routine medical examination, in which the doctor finds out whether the patient has an increased tension of the trapezius muscle, paravertebral points of the neck and thoracic spine. In this case, it is necessary to establish the absence of focal neurological symptoms.
If the deterioration of the patient’s well-being is not associated with overload of the pericranial muscles, then the pain is classified as a psychogenic disorder. Such pathology can be accompanied by a feeling of anxiety, depression, increased irritability in the premenstrual period in women, psychovegetative and asthenic disorders. Often there is an increase in blood pressure, tachycardia, panic attacks and lack of air.
Differential diagnosis of tension headache
A comprehensive examination is sometimes necessary to establish the fact that the patient’s brain has no organic lesions. It is necessary to differentiate GBN from various neurological and somatic diseases, one of the symptoms of which is the presence of headache.
For differential diagnosis, the patient is prescribed computed tomography and MRI, tomography of the cervical spine and dopplerography of the main arteries. Also, the patient is sent for laboratory tests: a general blood test, a biochemical study, a sugar test. Examinations of specialists are required: an optometrist, a therapist, an otolaryngologist. In case of fainting, the doctor may prescribe electroencephalography.
Treatment of tension headache
If the pain caused by tension is episodic, then its treatment will not be difficult. To do this, it is enough only to strictly follow a number of recommendations:
If possible, do sports;
Sleep at least 6-8 hours a day;
Being outdoors;
Take breaks from monotonous work;
Periodically take a break from working on the computer;
Pay attention to nutrition, limit the use of coffee, alcohol and fatty foods.
Only if making lifestyle changes does not give a positive result, you can use a light drug that helps reduce headaches: paracetamol, ibuprofen, aspirin.
The severe nature of the headache, recurring regularly, requires an individual approach from a specialist. The most commonly used method of treatment will be the appointment of antidepressants and drugs to the patient that eliminate the cause of the malaise. The course of treatment lasts from two to three months.
To prevent tension headaches, you should pay increased attention to your health: walk more often, adjust your regime and diet, get more positive emotions. This will help to get rid of the headache forever.
