Skip to main content

Advertisement

SpringerLink
Log in

Update of Chronic Tension-Type Headache

  • Chronic Daily Headache (SJ Wang, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Tension-type headache (TTH) is the most common type of primary headaches, and its chronic form, chronic tension-type headache (CTTH), is affecting 0.5 to 4.8 % of the worldwide population. Although the mechanism underlying CTTH remains unclear, the role of central versus peripheral mechanisms has always been discussed while explaining the pathogenesis of CTTH. There is always a debate on differential diagnosis between CTTH and chronic migraine without aura which are regarded as different aspects of chronic daily headache spectrum because of many similarities and fuzzy boundaries. Compared with pharmacological treatments, non-pharmacological treatments have been popular as alternative interventions for CTTH in recent years. This review summaries the update knowledge on CTTH and discusses the most interested questions regarding pathogenesis and therapeutic strategies of CTTH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Stovner L, Hagen K, Jensen R, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27(3):193–210.

    Article  PubMed  Google Scholar 

  2. Bendtsen L, Jensen R. Tension-type headache: the most common, but also the most neglected, headache disorder. Curr Opin Neurol. 2006;19(3):305–9.

    PubMed  Google Scholar 

  3. Headache Classification Committee of the International Headache S. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808.

    Article  Google Scholar 

  4. Headache Classification Committee of the International Headache S. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1988;8 Suppl 7:1–96.

    Google Scholar 

  5. Headache Classification Subcommittee of the International Headache S. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24 Suppl 1:9–160.

    Google Scholar 

  6. Robbins MS, Lipton RB. The epidemiology of primary headache disorders. Semin Neurol. 2010;30(2):107–19. This article is an excellent review of the epidemiology of all primary headache disorders.

    Article  PubMed  Google Scholar 

  7. Ferrante T, Manzoni GC, Russo M, et al. Prevalence of tension-type headache in adult general population: the PACE study and review of the literature. Neurol Sci. 2013;34 Suppl 1:S137–8.

    Article  PubMed  Google Scholar 

  8. Ayzenberg I, Katsarava Z, Sborowski A, et al. The prevalence of primary headache disorders in Russia: a countrywide survey. Cephalalgia. 2012;32(5):373–81.

    Article  CAS  PubMed  Google Scholar 

  9. Ertas M, Baykan B, Orhan EK, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain. 2012;13(2):147–57.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Yoon MS, Katsarava Z, Obermann M, et al. Prevalence of primary headaches in Germany: results of the German Headache Consortium Study. J Headache Pain. 2012;13(3):215–23.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Lavados PM, Tenhamm E. Epidemiology of tension-type headache in Santiago, Chile: a prevalence study. Cephalalgia. 1998;18(8):552–8.

    Article  CAS  PubMed  Google Scholar 

  12. Schwartz BS, Stewart WF, Simon D, Lipton RB. Epidemiology of tension-type headache. JAMA. 1998;279(5):381–3.

    Article  CAS  PubMed  Google Scholar 

  13. Lyngberg AC, Rasmussen BK, Jorgensen T, Jensen R. Has the prevalence of migraine and tension-type headache changed over a 12-year period? A Danish population survey. Eur J Epidemiol. 2005;20(3):243–9.

    Article  PubMed  Google Scholar 

  14. Russell MB. Tension-type headache in 40-year-olds: a Danish population-based sample of 4000. J Headache Pain. 2005;6(6):441–7.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Russell MB, Levi N, Saltyte-Benth J, Fenger K. Tension-type headache in adolescents and adults: a population based study of 33,764 twins. Eur J Epidemiol. 2006;21(2):153–60.

    Article  PubMed  Google Scholar 

  16. Queiroz LP, Peres MF, Piovesan EJ, et al. A nationwide population-based study of tension-type headache in Brazil. Headache. 2009;49(1):71–8.

    Article  PubMed  Google Scholar 

  17. Yu S, Liu R, Zhao G, et al. The prevalence and burden of primary headaches in China: a population-based door-to-door survey. Headache. 2012;52(4):582–91.

    Article  PubMed  Google Scholar 

  18. Lu SR, Fuh JL, Chen WT, et al. Chronic daily headache in Taipei, Taiwan: prevalence, follow-up and outcome predictors. Cephalalgia. 2001;21(10):980–6.

    Article  CAS  PubMed  Google Scholar 

  19. Halker RB, Hastriter EV, Dodick DW. Chronic daily headache: an evidence-based and systematic approach to a challenging problem. Neurology. 2011;76(7 Suppl 2):S37–43.

    Article  PubMed  Google Scholar 

  20. Wang SJ, Fuh JL, Lu SR, et al. Chronic daily headache in Chinese elderly: prevalence, risk factors, and biannual follow-up. Neurology. 2000;54(2):314–9.

    Article  CAS  PubMed  Google Scholar 

  21. Dong Z, Di H, Dai W, et al. Application of ICHD-II criteria in a headache clinic of China. PLoS One. 2012;7(12):e50898.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Seyed Saadat SM, Hosseininezhad M, Bakhshayesh B, Hoseini M, Naghipour M. Epidemiology and clinical characteristics of chronic daily headache in a clinic-based cohort of Iranian population. Neurol Sci. 2014;35(4):565–70.

    Article  PubMed  Google Scholar 

  23. Schmidt-Hansen PT, Svensson P, Bendtsen L, Graven-Nielsen T, Bach FW. Increased muscle pain sensitivity in patients with tension-type headache. Pain. 2007;129(1–2):113–21.

    Article  PubMed  Google Scholar 

  24. Bendtsen L, Fernandez-de-la-Penas C. The role of muscles in tension-type headache. Curr Pain Headache Rep. 2011;15(6):451–8. This article is a good review of the evidence on peripheral muscle metabolism in the pathophysiology of TTH.

    Article  PubMed  Google Scholar 

  25. Ashina M, Stallknecht B, Bendtsen L, et al. In vivo evidence of altered skeletal muscle blood flow in chronic tension-type headache. Brain. 2002;125(Pt 2):320–6.

    Article  CAS  PubMed  Google Scholar 

  26. Ashina M, Stallknecht B, Bendtsen L, et al. Tender points are not sites of ongoing inflammation—in vivo evidence in patients with chronic tension-type headache. Cephalalgia. 2003;23(2):109–16.

    Article  CAS  PubMed  Google Scholar 

  27. Fernandez-de-las-Penas C, Falla D, Arendt-Nielsen L, Farina D. Cervical muscle co-activation in isometric contractions is enhanced in chronic tension-type headache patients. Cephalalgia. 2008;28(7):744–51.

    Article  CAS  PubMed  Google Scholar 

  28. Sohn JH, Choi HC, Jun AY. Differential patterns of muscle modification in women with episodic and chronic tension-type headache revealed using surface electromyographic analysis. J Electromyogr Kinesiol. 2013;23(1):110–7.

    Article  PubMed  Google Scholar 

  29. Schoenen J, Gerard P, De Pasqua V, Sianard-Gainko J. Multiple clinical and paraclinical analyses of chronic tension-type headache associated or unassociated with disorder of pericranial muscles. Cephalalgia. 1991;11(3):135–9.

    Article  CAS  PubMed  Google Scholar 

  30. Schoenen J, Gerard P, De Pasqua V, Juprelle M. EMG activity in pericranial muscles during postural variation and mental activity in healthy volunteers and patients with chronic tension type headache. Headache. 1991;31(5):321–4.

    Article  CAS  PubMed  Google Scholar 

  31. Ashina M, Bendtsen L, Jensen R, Sakai F, Olesen J. Muscle hardness in patients with chronic tension-type headache: relation to actual headache state. Pain. 1999;79(2–3):201–5.

    Article  CAS  PubMed  Google Scholar 

  32. Rollnik JD, Karst M, Fink M, Dengler R. Botulinum toxin type A and EMG: a key to the understanding of chronic tension-type headaches? Headache. 2001;41(10):985–9.

    Article  CAS  PubMed  Google Scholar 

  33. Fernandez-de-Las-Penas C, Bueno A, Ferrando J, Elliott JM, Cuadrado ML, Pareja JA. Magnetic resonance imaging study of the morphometry of cervical extensor muscles in chronic tension-type headache. Cephalalgia. 2007;27(4):355–62.

    Article  CAS  PubMed  Google Scholar 

  34. Bendtsen L. Central sensitization in tension-type headache—possible pathophysiological mechanisms. Cephalalgia. 2000;20(5):486–508.

    Article  CAS  PubMed  Google Scholar 

  35. Fernandez-de-Las-Penas C, Alonso-Blanco C, Cuadrado ML, Gerwin RD, Pareja JA. Myofascial trigger points and their relationship to headache clinical parameters in chronic tension-type headache. Headache. 2006;46(8):1264–72.

    Article  PubMed  Google Scholar 

  36. Fernandez-de-Las-Penas C. What do we know about chronic tension-type headache? Discov Med. 2009;8(43):232–6.

    PubMed  Google Scholar 

  37. Shah JP, Phillips TM, Danoff JV, Gerber LH. An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol. 2005;99(5):1977–84.

    Article  CAS  PubMed  Google Scholar 

  38. Shah JP, Danoff JV, Desai MJ, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil. 2008;89(1):16–23.

    Article  PubMed  Google Scholar 

  39. Buchgreitz L, Lyngberg AC, Bendtsen L, Jensen R. Increased pain sensitivity is not a risk factor but a consequence of frequent headache: a population-based follow-up study. Pain. 2008;137(3):623–30.

    Article  CAS  PubMed  Google Scholar 

  40. Soee AB, Thomsen LL, Kreiner S, Tornoe B, Skov L. Altered pain perception in children with chronic tension-type headache: is this a sign of central sensitisation? Cephalalgia. 2013;33(7):454–62.

    Article  PubMed  Google Scholar 

  41. Russell MB. Genetics of tension-type headache. J Headache Pain. 2007;8(2):71–6.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Park JW, Kim JS, Lee HK, Kim YI, Lee KS. Serotonin transporter polymorphism and harm avoidance personality in chronic tension-type headache. Headache. 2004;44(10):1005–9.

    Article  PubMed  Google Scholar 

  43. Fernandez-de-las-Penas C, Ambite-Quesada S, Rivas-Martinez I, et al. Genetic contribution of catechol-O-methyltransferase polymorphism (Val158Met) in children with chronic tension-type headache. Pediatr Res. 2011;70(4):395–9.

    Article  CAS  PubMed  Google Scholar 

  44. Battistutta S, Aliverti R, Montico M, Zin R, Carrozzi M. Chronic tension-type headache in adolescents. Clinical and psychological characteristics analyzed through self- and parent-report questionnaires. J Pediatr Psychol. 2009;34(7):697–706.

    Article  PubMed  Google Scholar 

  45. Singh AK, Shukla R, Trivedi JK, Singh D. Association of psychiatric co-morbidity and efficacy of treatment in chronic daily headache in Indian population. J Neurosci Rural Pract. 2013;4(2):132–9.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Yucel B, Kora K, Ozyalcin S, Alcalar N, Ozdemir O, Yucel A. Depression, automatic thoughts, alexithymia, and assertiveness in patients with tension-type headache. Headache. 2002;42(3):194–9.

    Article  PubMed  Google Scholar 

  47. Cathcart S, Winefield AH, Lushington K, Rolan P. Stress and tension-type headache mechanisms. Cephalalgia. 2010;30(10):1250–67.

    Article  PubMed  Google Scholar 

  48. Ashina S, Bendtsen L, Ashina M, Magerl W, Jensen R. Generalized hyperalgesia in patients with chronic tension-type headache. Cephalalgia. 2006;26(8):940–8.

    Article  CAS  PubMed  Google Scholar 

  49. Cathcart S, Bhullar N, Immink M, Della Vedova C, Hayball J. Pain sensitivity mediates the relationship between stress and headache intensity in chronic tension-type headache. Pain Res Manag. 2012;17(6):377–80.

    PubMed Central  PubMed  Google Scholar 

  50. Prakash S, Shah ND. Chronic tension-type headache with vitamin D deficiency: casual or causal association? Headache. 2009;49(8):1214–22.

    Article  PubMed  Google Scholar 

  51. Prakash S, Kumar M, Belani P, Susvirkar A, Ahuja S. Interrelationships between chronic tension-type headache, musculoskeletal pain, and vitamin D deficiency: is osteomalacia responsible for both headache and musculoskeletal pain? Ann Indian Acad Neurol. 2013;16(4):650–8.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Della Vedova C, Cathcart S, Dohnalek A, et al. Peripheral interleukin-1ss levels are elevated in chronic tension-type headache patients. Pain Res Manag. 2013;18(6):301–6.

    PubMed  Google Scholar 

  53. Schramm SH, Obermann M, Katsarava Z, Diener HC, Moebus S, Yoon MS. Epidemiological profiles of patients with chronic migraine and chronic tension-type headache. J Headache Pain. 2013;14(1):40.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Fumal A, Schoenen J. Tension-type headache: current research and clinical management. Lancet Neurol. 2008;7(1):70–83.

    Article  CAS  PubMed  Google Scholar 

  55. Liang J, Liu X, Pan M, et al. Blockade of Na1.8 currents in nociceptive trigeminal neurons contributes to anti-trigeminovascular nociceptive effect of amitriptyline. Neuromolecular medicine. 2013;16:308–21.

    Article  PubMed  Google Scholar 

  56. Liang J, Liu X, Zheng J, Yu S. Effect of amitriptyline on tetrodotoxin-resistant Nav1.9 currents in nociceptive trigeminal neurons. Mol Pain. 2013;9:31.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  57. Torrente Castells E, Vazquez Delgado E, Gay Escoda C. Use of amitriptyline for the treatment of chronic tension-type headache. Med Oral Patol Oraly Cir Bucal. 2008;13(9):E567–72.

    Google Scholar 

  58. de Tommaso M, Shevel E, Libro G, et al. Effects of amitriptyline and intra-oral device appliance on clinical and laser-evoked potentials features in chronic tension-type headache. Neurol Sci. 2005;26 Suppl 2:s152–4.

    Article  PubMed  Google Scholar 

  59. Bettucci D, Testa L, Calzoni S, Mantegazza P, Viana M, Monaco F. Combination of tizanidine and amitriptyline in the prophylaxis of chronic tension-type headache: evaluation of efficacy and impact on quality of life. J Headache Pain. 2006;7(1):34–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  60. Martin-Araguz A, Bustamante-Martinez C, de Pedro-Pijoan JM. Treatment of chronic tension type headache with mirtazapine and amitriptyline. Rev Neurol. 2003;37(2):101–5.

    CAS  PubMed  Google Scholar 

  61. Bendtsen L, Buchgreitz L, Ashina S, Jensen R. Combination of low-dose mirtazapine and ibuprofen for prophylaxis of chronic tension-type headache. Eur J Neurol. 2007;14(2):187–93.

    Article  CAS  PubMed  Google Scholar 

  62. Holroyd KA, Labus JS, O’Donnell FJ, Cordingley GE. Treating chronic tension-type headache not responding to amitriptyline hydrochloride with paroxetine hydrochloride: a pilot evaluation. Headache. 2003;43(9):999–1004.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Lampl C, Marecek S, May A, Bendtsen L. A prospective, open-label, long-term study of the efficacy and tolerability of topiramate in the prophylaxis of chronic tension-type headache. Cephalalgia. 2006;26(10):1203–8.

    Article  CAS  PubMed  Google Scholar 

  64. Lindelof K, Bendtsen L. Memantine for prophylaxis of chronic tension-type headache—a double-blind, randomized, crossover clinical trial. Cephalalgia. 2009;29(3):314–21.

    Article  CAS  PubMed  Google Scholar 

  65. Aurora SK, Dodick DW, Turkel CC, et al. OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 1 trial. Cephalalgia. 2010;30(7):793–803.

    Article  CAS  PubMed  Google Scholar 

  66. Diener HC, Dodick DW, Aurora SK, et al. OnabotulinumtoxinA for treatment of chronic migraine: results from the double-blind, randomized, placebo-controlled phase of the PREEMPT 2 trial. Cephalalgia. 2010;30(7):804–14.

    Article  CAS  PubMed  Google Scholar 

  67. Schulte-Mattler WJ, Wieser T, Zierz S. Treatment of tension-type headache with botulinum toxin: a pilot study. Eur J Med Res. 1999;4(5):183–6.

    CAS  PubMed  Google Scholar 

  68. Porta M. A comparative trial of botulinum toxin type A and methylprednisolone for the treatment of tension-type headache. Curr Rev Pain. 2000;4(1):31–5.

    Article  CAS  PubMed  Google Scholar 

  69. Erdemoglu AK, Varlibas A. The long-term efficacy and safety of botulinum toxin in refractory chronic tension-type headache. J Headache Pain. 2007;8(5):294–300.

    Article  CAS  PubMed  Google Scholar 

  70. Hamdy SM, Samir H, El-Sayed M, Adel N, Hasan R. Botulinum toxin: could it be an effective treatment for chronic tension-type headache? J Headache Pain. 2009;10(1):27–34.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  71. Silberstein SD, Gobel H, Jensen R, et al. Botulinum toxin type A in the prophylactic treatment of chronic tension-type headache: a multicentre, double-blind, randomized, placebo-controlled, parallel-group study. Cephalalgia. 2006;26(7):790–800.

    Article  CAS  PubMed  Google Scholar 

  72. Straube A, Empl M, Ceballos-Baumann A, Tolle T, Stefenelli U, Pfaffenrath V. Pericranial injection of botulinum toxin type A (Dysport) for tension-type headache—a multicentre, double-blind, randomized, placebo-controlled study. Eur J Neurol. 2008;15(3):205–13.

    Article  CAS  PubMed  Google Scholar 

  73. Schulte-Mattler WJ, Krack P. Treatment of chronic tension-type headache with botulinum toxin A: a randomized, double-blind, placebo-controlled multicenter study. Pain. 2004;109(1–2):110–4.

    Article  CAS  PubMed  Google Scholar 

  74. Harden RN, Cottrill J, Gagnon CM, et al. Botulinum toxin a in the treatment of chronic tension-type headache with cervical myofascial trigger points: a randomized, double-blind, placebo-controlled pilot study. Headache. 2009;49(5):732–43.

    Article  PubMed  Google Scholar 

  75. Jackson JL, Kuriyama A, Hayashino Y. Botulinum toxin A for prophylactic treatment of migraine and tension headaches in adults: a meta-analysis. JAMA. 2012;307(16):1736–45.

    Article  CAS  PubMed  Google Scholar 

  76. Lattes K, Venegas P, Lagos N, et al. Local infiltration of gonyautoxin is safe and effective in treatment of chronic tension-type headache. Neurol Res. 2009;31(3):228–33.

    Article  CAS  PubMed  Google Scholar 

  77. Karadas O, Gul HL, Inan LE. Lidocaine injection of pericranial myofascial trigger points in the treatment of frequent episodic tension-type headache. J Headache Pain. 2013;14(1):44.

    Article  PubMed Central  PubMed  Google Scholar 

  78. Smitherman TA, Penzien DB, Rains JC. Challenges of nonpharmacologic interventions in chronic tension-type headache. Curr Pain Headache Rep. 2007;11(6):471–7.

    Article  PubMed  Google Scholar 

  79. Nestoriuc Y, Rief W, Martin A. Meta-analysis of biofeedback for tension-type headache: efficacy, specificity, and treatment moderators. J Consult Clin Psychol. 2008;76(3):379–96.

    Article  PubMed  Google Scholar 

  80. Holroyd KA, O’Donnell FJ, Stensland M, Lipchik GL, Cordingley GE, Carlson BW. Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: a randomized controlled trial. JAMA. 2001;285(17):2208–15.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  81. Holroyd KA, Labus JS, Carlson B. Moderation and mediation in the psychological and drug treatment of chronic tension-type headache: the role of disorder severity and psychiatric comorbidity. Pain. 2009;143(3):213–22.

    Article  PubMed Central  PubMed  Google Scholar 

  82. Verhagen AP, Damen L, Berger MY, Passchier J, Koes BW. Behavioral treatments of chronic tension-type headache in adults: are they beneficial? CNS Neurosci Ther. 2009;15(2):183–205.

    Article  PubMed  Google Scholar 

  83. Penzien DB, Rains JC, Lipchik GL, Creer TL. Behavioral interventions for tension-type headache: overview of current therapies and recommendation for a self-management model for chronic headache. Curr Pain Headache Rep. 2004;8(6):489–99.

    Article  PubMed  Google Scholar 

  84. Abdoli S, Rahzani K, Safaie M, Sattari A. A randomized control trial: the effect of guided imagery with tape and perceived happy memory on chronic tension type headache. Scand J Caring Sci. 2012;26(2):254–61.

    Article  PubMed  Google Scholar 

  85. Cathcart S, Galatis N, Immink M, Proeve M, Petkov J. Brief mindfulness-based therapy for chronic tension-type headache: a randomized controlled pilot study. Behav Cogn Psychother. 2014;42(1):1–15.

    Article  PubMed  Google Scholar 

  86. Castien RF, van der Windt DA, Grooten A, Dekker J. Effectiveness of manual therapy for chronic tension-type headache: a pragmatic, randomised, clinical trial. Cephalalgia. 2011;31(2):133–43.

    Article  PubMed  Google Scholar 

  87. Fernandez-de-Las-Penas C, Alonso-Blanco C, Cuadrado ML, Miangolarra JC, Barriga FJ, Pareja JA. Are manual therapies effective in reducing pain from tension-type headache? A systematic review. Clin J Pain. 2006;22(3):278–85.

    Article  PubMed  Google Scholar 

  88. Castien R, Blankenstein A, van der Windt D, Heymans MW, Dekker J. The working mechanism of manual therapy in participants with chronic tension-type headache. J Orthop Sports Phys Ther. 2013;43(10):693–9.

    Article  PubMed  Google Scholar 

  89. Melchart D, Streng A, Hoppe A, et al. The acupuncture randomised trial (ART) for tension-type headache—details of the treatment. Acupunct Med. 2005;23(4):157–65.

    Article  PubMed  Google Scholar 

  90. Ebneshahidi NS, Heshmatipour M, Moghaddami A, Eghtesadi-Araghi P. The effects of laser acupuncture on chronic tension headache—a randomised controlled trial. Acupunct Med. 2005;23(1):13–8.

    Article  PubMed  Google Scholar 

  91. Soderberg E, Carlsson J, Stener-Victorin E. Chronic tension-type headache treated with acupuncture, physical training and relaxation training. Between-group differences. Cephalalgia. 2006;26(11):1320–9.

    Article  CAS  PubMed  Google Scholar 

  92. Mousavi SA, Mirbod SM, Khorvash F. Comparison between efficacy of imipramine and transcutaneous electrical nerve stimulation in the prophylaxis of chronic tension-type headache: a randomized controlled clinical trial. J Res Med Sci. 2011;16(7):923–7.

    PubMed Central  PubMed  Google Scholar 

  93. Lindelof K, Jung K, Ellrich J, Jensen R, Bendtsen L. Low-frequency electrical stimulation induces long-term depression in patients with chronic tension-type headache. Cephalalgia. 2010;30(7):860–7.

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Shengyuan Yu and Dr. Xun Han each declare no potential conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China

    Shengyuan Yu & Xun Han

  2. Medical Center, Tsinghua University, Beijing, 100084, China

    Xun Han

Authors
  1. Shengyuan Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xun Han
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shengyuan Yu.

Additional information

This article is part of the Topical Collection on Chronic Daily Headache

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yu, S., Han, X. Update of Chronic Tension-Type Headache. Curr Pain Headache Rep 19, 469 (2015). https://doi.org/10.1007/s11916-014-0469-5

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11916-014-0469-5

Keywords

Search

Navigation