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Tension headache

Tension headache is a type of muscle painin the head. It is a very generic term that is often used by doctors to indicate pain, twinging or muscle tension in the face. 
The headache can originate in different organs or body structures: eyes, hypertension , nerves, brain, etc., but the most frequent cause is the tension of muscles and ligaments. 
There is also migraine of tension origin, which can be with or without aura.

You may feel a throbbing pain across the face or it may be one sided (just right or left).

How many medications did you take for a headache without resolving the symptom? After how long does the pain come back again? 
If the headache you are suffering from is a tension-type headache, these questions can make you think.


When it comes to skull and face, we think there are just a few bones together, instead there are many fundamental and often used muscles that allow for example eye movement, jaw and show the mood or emotions (wrinkling the forehead, etc.). 
Just as you may have a thigh contracture , you can find the same conditions in the muscles of the head which, therefore, cause headaches. 
Some people suffer from episodic headache, ie on some rare or particularly stressful days due to incessant thoughts and resolve when you eliminate the source of the problem. 
Chronic tension headache often happens once or twice a week and the symptoms can stay up to 1-2 days.
The people most affected are young and adult females, especially those who have a sedentary lifestyle.


What are the symptoms of tension headache? When they appear?

Patient with headache 
© Christopher Hall – Fotolia.com

Everyone thinks that tension headache should be accompanied by neck pain(which is commonly called “cervical”). This happens often but not always, in fact can only hurt the muscles of the head and the face. 
Muscle tension headache can affect the face, the back of the skull (the nape of the neck), the temples, or a vertical band that originates at the base of the occiput and rises posteriorly until it causes pain in the eyes.

The pain can be throbbing and high intensity, or you may feel tension and pain.

Tension headache is often accompanied by dizziness , neck pain in the upper part, and in rare cases is accompanied by nausea . 
This disorder has a negative effect on mood, sufferers are more nervous and anxious, experience a decrease in concentration. Some people close themselves in a dark room because they suffer from photophobia and phonophobia, that is, intolerance to light and sounds.


What are the causes of tension headache?

Tension headache can depend on many factors:

  • Bad mood, stress, depression and anxiety;
  • Trauma, such as a car accident with whiplash ;
  • Surgery as for a cervical hernia ;
  • Cervical disorders of the postural type;
  • Bruxism (grinding teeth) and dental malocclusion;
  • Extraction of teeth and dental interventions;
  • Certain foods such as chocolate;
  • Digestive problems;
  • Fasting and lowering of blood sugar;
  • There are theories about the low levels of serotonin or a hyperexcitability of the neurons that carry the signal of pain;
  • Menstrual cycle  in women;
  • The contraceptive pill or hormone replacement therapy;
  • Places with people who smoke .

The causes of headache in children are stress and bruxism . 
In pregnancy , many women have headaches in the first trimester due to hormonal changes.

How is the differential diagnosis performed?

To understand which headache you suffer from, the doctor asks,

  • Where precisely the pain is located,
  • At what time of the day or week occurs,
  • As it began,
  • If it can be associated with the power supply and in particular with certain foods,
  • If you also take medicines for other diseases.

Other types of headache are very painful, especially trigeminal neuralgia : a cranial nerve that innervates almost the entire face causing stitches when certain movements of the face and jaw are performed. 
Depending on the frequency of recurrences, a sporadic headache of a chronic daily headache is distinguished. 
If the doctor has questions you may prescribe an MRI or CT scan of the brain to understand if there are serious causes like tumors. 
The specialist doctor who cares for headache is the neurologist who will work with a team with other professionals. After excluding any possible systemic causes, the neurologist usually makes a diagnosis of tension headache.


What to do? What is the treatment for tension headache?

The best treatment for tension-type headache comes from a careful assessment of the disorder to find the cause: medications, diet, lifestyle, etc. 
If the cause is food or medicines, simply rule out the risk factor to resolve the situation. 
In other cases, especially if the patient has undergone surgery, extraction of teeth, if a car accident has occurred or if the headache is of cervical origin , the most indicated treatment is the manual, to remove adhesions, to dissolve the contracturesand muscle elasticity for proper joint mobility. 
With manual physiotherapy (such as myofascial manipulation or Mckenzie exercises) is eliminated because of pain, so its effectiveness is long term.

If the cause of the headache is bruxism, you can fix it with a plaque for bruxism to maintain overnight.


What medications can be taken?

Analgesic or anti-inflammatory drugs , if taken in a timely manner, may mitigate or resolve the pain during this episode, but do not act on the source of the headache, so after two days the pain may return.


Natural Remedies

There are many possible home remedies for tension headache. 
Some studies show that acupuncture is useful for temporarily reducing pain caused by tension headache. 
Sport is an excellent remedy for tension headache because it reduces nervous tension and improves the functionality of the whole body. 
Do not put ice on the forehead or painful areas, avoid placing a cold compress on the neck.


How long does tension headache last? The prognosis

The healing time is difficult to establish because the acute headache can last from a few hours to 3 days, but in the case of chronic headache the patient may have a relapse almost every day.

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