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Yogi’s Headache: Chronic Tension-Type Headache

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Chronic Headache

Abstract

Tension-type headache (TTH) is the second most common condition worldwide (surpassed only by dental carries). As seen in migraine, TTH may progress to a chronic state. It is estimated that the incidence for chronic tension-type headache (CTTH) in the USA is 2.2%. Pericranial muscle tenderness is the most common finding in both episodic (ETTH) and CTTTH. The increased nociceptive CNS input from the cephalic and extracephalic musculature initiates a “feedback loop” that may lead to central sensitization by increasing the attention and emotional response to pain. Active and passive trigger points are frequently present in TTH. The presence of active trigger points has been shown to have a role in CTTH progression. As seen in other chronic pain states, in CTTH central mechanism of hyperexcitability and impaired inhibitory response have a role in pathogenesis.

Tension-type headache comorbidities include insomnia, depression, neck pain, and temporomandibular joint disorder. Insomnia is especially associated to CTTH chronification. Treatments for ETTH appear to be more effective than for CTTH. The treatments outlined here involve pharmacological, behavioral, physical, and procedural interventions.

Tension-type headache remains an underdiagnosed and undertreated entity with poorly understood pathophysiology. However, the burden of tension-type headache both individually and societally is significant, and its association with stress suggested tension-type headache may be a marker for a variety of social and personal circumstances that require attention.

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Notes

  1. 1.

    As measured on the Medical Outcomes Study SF-36

References

  1. Bezov D, Ashina S, Jensen R, Bendtsen L. Pain perception studies in tension-type headache. Headache. 2011;51(2):262–71.

    Article  PubMed  Google Scholar 

  2. Fernández-de-las-Peñas C, Schoenen J. Chronic tension-type headache: what is new? Curr Opin Neurol. 2009;22(3):254–61.

    Article  PubMed  Google Scholar 

  3. Kaniecki R, Diamond S, Cady RK, Diamond ML, Martin VT. Headache and migraine biology and management. New York: Academic; 2015.

    Google Scholar 

  4. de Tommaso M, Fernández-de-Las-Penas C. Tennsion type headache. Curr Rheumatol Rev. 2016;12(2):127–39.

    Article  PubMed  Google Scholar 

  5. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia. 1998;8(Suppl 7):1–96.

    Google Scholar 

  6. Rasmussen BK, Jensen R, Olesen J. A population-based analysis of the criteria of the International Headache Society. Cephalalgia. 1991;11:129–34.

    Article  PubMed  CAS  Google Scholar 

  7. Turkdogan D, Cagirici S, Soylemez D, et al. Characteristics and overlapping features of migraine and tension-type headache. Headache. 2006;46:461–8.

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  9. Schwartz BS, Stewart WF, Simon D, Lipton R. Epidemiology of tension-type headache. JAMA. 1998;279:381–3.

    Article  PubMed  CAS  Google Scholar 

  10. 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 

  11. Rasmussen BK, Jensen R, Olesen J. Epidemiology of tension-type headache in a general population. In: Olesen J, Schoenen J, editors. Tension-type headache: classification, mechanisms, and treatment. New York: Raven Press; 1993. p. 9–13.

    Google Scholar 

  12. Rasmussen B, Jensen R, Olesen J. Impact of headache on sickness absence and utilization of medical services: a Danish population study. J Epidemiol Community Health. 1992;46:443–6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

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

    PubMed  Google Scholar 

  14. Cady RK. The convergence hypothesis. Headache. 2007;47:S44–51.

    Article  PubMed  Google Scholar 

  15. Kaniecki RG. Tension-type headache. Continuum (Minneap Minn). 2012;18(4):823–34.

    Google Scholar 

  16. Kanaan RA, Lepine JP, Wessely SC. The association or otherwise of the functional somatic syndromes. Psychosom Med. 2007;69:855–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Marcus DA, Bernstein C, Rudy TE. Fibromyalgia and headache: an epidemiological study supporting migraine as part of the fibromyalgia syndrome. Clin Rheumatol. 2005;24:595–601.

    Article  PubMed  Google Scholar 

  18. Bendtsen L, Jensen R. Tension-type headaches. Neurol Clin. 2009;27:525–35.

    Article  PubMed  Google Scholar 

  19. Jensen R. Pathophysiological mechanisms of tension-type headache: a review of epidemiological and experimental studies. Cephalalgia. 1999;19:602–21.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  21. Jensen R, Fuglsang-Frederiksen A, Olesen J. Quantitative surface EMG of pericranial muscles in headache: a population study. Electroencephalogr Clin Neurophysiol. 1994;93:355–44.

    Google Scholar 

  22. Filatova E, Latysheva N, Kurenkov A. Evidence of persistent central sensitization in chronic headaches: a multimethod study. J Headache Pain. 2008;9:295–300.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Ashina S, Bendtsen L, Ashina M, et al. Generalized hyperalgesia in patients with chronic tension type headache. Cephalalgia. 2006;26:940–8.

    Article  PubMed  CAS  Google Scholar 

  24. de Tommaso M, Libro G, Guido M, Sciruicchio V, Losito L, Puca F. Heat pain thresholds and cerebral event-related potentials following painful CO2 laser stimulation in chronic tension-type headache. Pain. 2003;104:111–9.

    Article  PubMed  Google Scholar 

  25. Buchgreitz L, Egsgaard LL, Jensen R, Arendt-Nielsen L, Bendtsen L. Abnormal pain processing in chronic tension-type headache: a high-density EEG brain mapping study. Brain. 2008;131:3232–8.

    Article  PubMed  CAS  Google Scholar 

  26. Sohn J, Choi H, Kim C. Differences between episodic and chronic tension-type headache in nociceptive-specific trigeminal pathways. Cephalalgia. 2013;33:330–9.

    Article  PubMed  Google Scholar 

  27. 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;23:109–16.

    Article  PubMed  CAS  Google Scholar 

  28. Shah JP, Danoff JV, Desai MJ, et al. Bio-chemicals associated with pain and inflammations are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil. 2008;89:16–23.

    Article  PubMed  Google Scholar 

  29. Arendt-Nielsen L. Headache: muscle tension, trigger points and referred pain. Int J Clin Pract Suppl. 2015;(182):8–12.

    Google Scholar 

  30. Ashina M, Bendtsen L, Jensen R, et al. Plasma levels of calcitonin gene-related peptide in chronic tension-type headache. Neurology. 2000;55:1335–40.

    Article  PubMed  CAS  Google Scholar 

  31. Metsahonkala L, Anttila P, Laimi K, et al. Extra-cephalic tenderness and pressure pain threshold in children with headache. Eur J Pain. 2006;10:581–5.

    Article  PubMed  Google Scholar 

  32. Anttila P, Metsähonkala L, Mikkelsson M, et al. Muscle tenderness in pericranial and neck-shoulder region in children with headache: a controlled study. Cephalalgia. 2002;22:340–4.

    Article  PubMed  CAS  Google Scholar 

  33. Soee AB, Skov L, Kreiner S, Tornoe B, Thomsen LL. Pain sensitivity and peri-cranial tenderness in children with tension-type headache: a controlled study. J Pain Res. 2013;6:425–34.

    Article  PubMed  PubMed Central  Google Scholar 

  34. de Tommaso M, Shevel E, Pecoraro C, et al. Topographic analysis of laser evoked potentials in chronic tension-type headache: correlations with clinical features. Int J Psychophysiol. 2006;62:38–45.

    Article  PubMed  Google Scholar 

  35. Engstrøm M, Hagen K, Bjørk M, Stovner LJ, Stjern M, Sand T. Sleep quality, arousal and pain thresholds in tension-type headache: a blinded controlled polysomnographic study. Cephalalgia. 2014;34:455–63.

    Article  PubMed  Google Scholar 

  36. Drummond P. Scalp tenderness and sensitivity to pain in migraine and tension headache. Headache. 1987;27:45–50.

    Article  PubMed  CAS  Google Scholar 

  37. Lipchik GL, Holroyd KA, O’Donnell FJ, et al. Exteroceptive suppression periods and pericranial muscle tenderness in chronic tension-type head-ache: effects of psychopathology, chronicity and disability. Cephalalgia. 2000;20:638–46.

    Article  PubMed  CAS  Google Scholar 

  38. Schoenen J, Bottin D, Hardy F, Gerard P. Cephalic and extra-cephalic pressure pain thresholds in chronic tension type headache. Pain. 1991;47:145–9.

    Article  PubMed  CAS  Google Scholar 

  39. Sandrini G, Antonaci F, Pucci E, Bono G, Nappi G. Comparative study with EMG, pressure algometry and manual palpation in tension-type headache and migraine. Cephalalgia. 1994;14:451–7.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  41. Mørk H, Ashina M, Bendtsen L, Olesen J, Jensen R. Induction of prolonged tenderness in patients with tension-type headache by means of a new experimental model of myofascial pain. Eur J Neurol. 2003;10:249–56.

    Article  PubMed  Google Scholar 

  42. Fernández-de-las-Penas C, Ge HY, Cuadrado ML, et al. Bilateral pressure pain sensitivity mapping of the temporalis muscle in chronic tension type headache. Headache. 2008;48:1067–75.

    Article  PubMed  Google Scholar 

  43. Simons DG, Travell J, Simons LS. Myofascial pain and dysfunction: the trigger point manual, vol. 1. 2nd ed. Baltimore, MD: Williams & Wilkins; 1999.

    Google Scholar 

  44. Fernandez-de-las-Penas C, Cuadrado ML, Arendt-Nielsen L, Simons DG, Pareja JA. Myofascial trigger points and sensitization: an updated pain model for tension-type headache. Cephalalgia. 2007;27:383–93.

    Article  PubMed  CAS  Google Scholar 

  45. Marcus DA, Scharff L, Mercer S, Turk DC. Musculoskeletal abnormalities in chronic headache: a controlled comparison of headache diagnostic groups. Headache. 1999;39:21–7.

    Article  PubMed  CAS  Google Scholar 

  46. Fernández-de-las-Penas C, Simons DG, Gerwin RD, et al. Muscle trigger points in tension type headache. In: Fernández-de-las-Penas C, Arendt-Nielsen L, Gerwin RD, editors. Tension type and cervicogenic headache: pathophysiology, diagnosis and treatment. Baltimore: Jones & Bartlett; 2009. p. 61–76.

    Google Scholar 

  47. Fernández-de-las-Penas C, Alonso-Blanco C, Cuadrado ML, et al. Trigger points in the suboccipital muscles and forward head posture in tension type headache. Headache. 2006;46:454–60.

    Article  PubMed  Google Scholar 

  48. Fernández-de-las-Penas C, Ge H, Arendt-Nielsen L, et al. Referred pain from trapezius muscle trigger point shares similar characteristics with chronic tension type headache. Eur J Pain. 2007;11:475–82.

    Article  PubMed  Google Scholar 

  49. Fernández-de-las-Penas C, Cuadrado ML, Gerwin RD, Pareja JA. Referred pain from the trochlear region in tension-type headache: a myofascial trigger point from the superior oblique muscle. Headache. 2005;45:731–7.

    Article  PubMed  Google Scholar 

  50. Fernández-de-las-Penas C, Alonso-Blanco C, Cuadrado ML, et al. Myofascial trigger points and their relationship with headache clinical parameters in chronic tension type headache. Headache. 2006;46:1264–72.

    Article  PubMed  Google Scholar 

  51. Fernández-de-las-Penas C, Ge H, Arendt-Nielsen L, et al. The local and referred pain from myofascial trigger points in the temporalis muscle contributes to pain profile in chronic tension-type headache. Clin J Pain. 2007;23:786–92.

    Article  PubMed  Google Scholar 

  52. Fernández-de-las-Penas C, Cuadrado ML, Gerwin RD, Pareja JA. Referred pain from the lateral rectus muscle in subjects with chronic tension type headache. Pain Med. 2009;10:43–8.

    Article  PubMed  Google Scholar 

  53. Fernández-de-las-Peñas C, Arendt-Nielsen L, Simons DG, Cuadrado ML, Pareja JA. Sensitization in tension type headache: a pain model. In: Fernández-de-las-Peñas C, Arendt-Nielsen L, Gerwin RD, editors. Tension type and cervicogenic headache: pathophysiology, diagnosis and treatment. Baltimore, MD: Jones & Bartlett; 2009. p. 97–106.

    Google Scholar 

  54. Fernández-de-las-Penas C, Alonso-Blanco C, Cuadrado ML, Pareja JA. Forward head posture and neck mobility in chronic tension type headache: a blinded, controlled study. Cephalalgia. 2006;26:314–9.

    Article  PubMed  Google Scholar 

  55. Fernández-de-las-Penas C, Bueno A, Ferrando J, et al. Magnetic resonance imaging of the morphometry of cervical extensor muscles in chronic tension type headache. Cephalalgia. 2007;27:355–62.

    Article  PubMed  Google Scholar 

  56. Fernández-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. Cephalalgia. 2008;28:744–51.

    Article  PubMed  Google Scholar 

  57. Penacoba-Puente C, Fernández-de-las-Penas C, González-Gutiérrez JL, et al. Mediating or moderating effect of anxiety and depression in headache clinical parameters and quality of life in chronic tension type headache. Eur J Pain. 2008;12:886–94.

    Article  PubMed  Google Scholar 

  58. Bendtsen L, Schoenen J. Synthesis of tension type headache mechanisms. In: Olesen J, Goasdby P, Ramdan NM, Tfelt-Hansen P, Welch KMA, editors. The headaches. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2006.

    Google Scholar 

  59. Bendtsen L. Central sensitization in tension-type headache: possible pathophysiological mechanisms. Cephalalgia. 2000;20:486–508.

    Article  PubMed  CAS  Google Scholar 

  60. Abboud J, Marchand A, Sorra K, Descarreaux M. Musculoskeletal physical outcome measures in individuals with tension-type headache: a scoping review. Cephalalgia. 2013;33:1319–36.

    Article  PubMed  Google Scholar 

  61. Carli G, Suman AL, Biasi G, Marcolongo R. Reactivity to superficial and deep stimuli in patients with chronic musculoskeletal pain. Pain. 2002;100:259–69.

    Article  PubMed  Google Scholar 

  62. de Tommaso M, Sardaro M, Serpino C, et al. Fibromyalgia comorbidity in primary headaches. Cephalalgia. 2009;29:453–64.

    Article  PubMed  Google Scholar 

  63. de Tommaso M, Federici A, Serpino C, et al. Clinical features of headache patients with fibromyalgia comorbidity. J Headache Pain. 2011;12:629–38.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Langemark M, Olesen J. Pericranial tenderness in tension headache. A blind controlled study. Cephalalgia. 1987;7:249–55.

    Article  PubMed  CAS  Google Scholar 

  65. 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;137:623–30.

    Article  PubMed  CAS  Google Scholar 

  66. Bendtsen L, Fernandez-de-la-Penas C. The role of muscles in tension-type headache. Curr Pain Headache Rep. 2011;15(6):451–8.

    Article  PubMed  Google Scholar 

  67. Fernandez-de-la-Penas C, Cuadrado M, Pareja J. Myofascial trigger points, neck mobility, and forward head posture in episodic tension-type headache. Headache. 2007;47:662–72.

    Article  Google Scholar 

  68. Cathcart S, Winefield A, Lushington K, Rolan P. Stress and tension-type headache mechanisms. Cephalalgia. 2010;30:1250–67.

    Article  PubMed  Google Scholar 

  69. Jensen R, Bendtsen L, Olesen J. Muscular factors are of importance in tension-type headache. Headache. 1998;38:10–7.

    Article  PubMed  CAS  Google Scholar 

  70. Schmidt-Wilcke T, Leinisch E, Straube A, et al. Gray matter decrease in patients with chronic tension-type headache. Neurology. 2005;65:1483–6.

    Article  PubMed  CAS  Google Scholar 

  71. May A. Chronic pain may change the structure of the brain. Pain. 2008;137:7–15.

    Article  PubMed  Google Scholar 

  72. Apkarian AV, Baliki MN, Geha PY. Towards a theory of chronic pain. Prog Neurobiol. 2009;87:81–97.

    Article  PubMed  Google Scholar 

  73. Ostergaard S, Russell MB, Bendtsen L, Olesen J. Comparison of first degree relatives and spouses of people with chronic tension headache. Br Med J. 1997;14:1092–3.

    Article  Google Scholar 

  74. Russell MB, Iselius L, Østergaard S, Olesen J. Inheritance of chronic tension-type headache investigated by complex segregation analysis. Hum Genet. 1998;102:138–40.

    Article  PubMed  CAS  Google Scholar 

  75. Friederichs H, Olesen J, Russell M. Familial occurrence of chronic tension headache. Ugeskr Laeger. 1999;161:576–8.

    PubMed  CAS  Google Scholar 

  76. Ulrich V, Gervil M, Olesen J. The relative influence of environment and genes in episodic tension-type headache. Neurology. 2004;62:2065–9.

    Article  PubMed  Google Scholar 

  77. Cathcart S, Petkov J, Pritchard D. Effects of induced stress on experimental pain sensitivity in chronic tension-type headache sufferers. Eur J Neurol. 2008;15:552–8.

    Article  PubMed  CAS  Google Scholar 

  78. Buchgreitz L, Lyngberg A, Bendtsen L, Jensen R. Increased prevalence of tension-type headache over a 12-year period is related to increased pain sensitivity: a population study. Cephalalgia. 2007;27:145–52.

    Article  PubMed  CAS  Google Scholar 

  79. Lindelof K, Ellrich J, Jensen R, Bendtsen L. Central pain processing in chronic tension-type headache. Clin Neurophysiol. 2009;120:1364–70.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  81. Sacco S, Ricci S, Carolci A. Tension-type headache and systemic medical disorders. Curr Pain Headache Rep. 2011;15:438–43.

    Article  PubMed  Google Scholar 

  82. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33:629–808.

    Article  Google Scholar 

  83. Roehrs T, Hydae M, Blaisdell B, Greenwald M, Roth T. Sleep loss and REM sleep loss are hyperalgesic. Sleep. 2006;29:144–51.

    Article  Google Scholar 

  84. Odegard S, Sand T, Engstrom M, Stovner L, Zwart J, Hagen K. The long-term effect of insomnia on primary headaches: a prospective, population-based cohort study (HUNT-2 and HUNT-3). Headache. 2011;51:570–80.

    Article  PubMed  Google Scholar 

  85. Lyngberg A, Rasmussen B, Jorgensen T, Jensen R. Incidence of primary headache: a Danish epidemiologic follow-up study. Am J Epidemiol. 2005;161:1066–73.

    Article  PubMed  CAS  Google Scholar 

  86. Bellegaard V, Thede-Schmidt-Hansen P, Svensson P, Jensen R. Are headache and temporomandibular disorders related? A blinded study. Cephalagia. 2008;28:832–41.

    Article  Google Scholar 

  87. Glaros A, Urban D, Locke J. Headache and temporomandibular disorders: evidence for diagnostic and behavioral overlap. Cephalalgia. 2007;27:542–9.

    Article  PubMed  CAS  Google Scholar 

  88. Fernandez-de-las-Penas C, Galan-del-Rio F, Fernandez-Carnero J, Pesquera J, Arendt-Nielsen L, Svensson P. Bilateral widespread mechanical pain sensitivity in women with myofascial temporomandibular joint disorder: evidence of impairment of central nociceptive processing. J Pain. 2009;10:1170–8.

    Article  PubMed  Google Scholar 

  89. Ailani J. Chronic tension-type headache. Curr Pain Headache Rep. 2009;13(6):479–83.

    Article  PubMed  Google Scholar 

  90. Balottin U, Fusar Poli P, Termine C, Molteni S, Galli F. Psychopathological symptoms in child and adolescent migraine and tension-type headache: a meta-analysis. Cephalalgia. 2012;33:112–22.

    Article  PubMed  Google Scholar 

  91. Solomon G. Chronic tension-type headache: advice for the viselike-headache patient. Cleve Clin J Med. 2002;69:167–72.

    Article  PubMed  Google Scholar 

  92. Janke EA, Holryod KA, Romanek K. Depression increases onset of tension-type headache following laboratory stress. Pain. 2004;111:230–8.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Verhagen AP, de Vet HC, Willemsen S, Stijnen T. A meta-regression analysis shows no impact of design characteristics on outcome in trials on tension type headaches. J Clin Epidemiol. 2008;61:813–8.

    Article  PubMed  CAS  Google Scholar 

  94. Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G, Schoenen J, EFNS. EFNS guideline on the treatment of tension-type headache - report of an EFNS task force. Eur J Neurol. 2010;17:1318–25.

    Article  PubMed  CAS  Google Scholar 

  95. Semenov IA. Tension-type headaches. Dis Mon. 2015;61(6):233–5.

    Article  PubMed  Google Scholar 

  96. Packman E, Packman B, Thurston H, Tseng L. Lumiracoxib is effective in the treatment of episodic tension-type headache. Headache. 2005;45:1163–70.

    Article  PubMed  Google Scholar 

  97. Cady R, Gutterman D, Salers JA, Beach ME. Responsiveness of non-IHS migraine and tension-type headache to sumatriptan. Cephalalgia. 1997;17:588–90.

    Article  PubMed  CAS  Google Scholar 

  98. Bendtsen L, Jensen R. Mirtazapine is effective in the prophylactic treatment of chronic tension-type headache. Neurology. 2004;62:1706–11.

    Article  PubMed  CAS  Google Scholar 

  99. Zissis NP, Harmoussi S, Vlaikidis N, et al. A randomized, double-blind, placebo-controlled study of venlafaxine XR in out-patients with tension type headache. Cephalalgia. 2007;27:315–24.

    Article  PubMed  CAS  Google Scholar 

  100. Volpe FM. An 8-week open-label trial of duloxetine for comorbid major depressive disorder and chronic headache. J Clin Psychiatry. 2008;69:1449–54.

    Article  PubMed  CAS  Google Scholar 

  101. Bettucci D, Testa L, Calzoni S, et al. 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;7:34–6.

    Article  PubMed  CAS  Google Scholar 

  102. 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;26:1203–8.

    Article  PubMed  CAS  Google Scholar 

  103. Straube A, Empl M, Ceballos-Baumann A, et al. Peri-cranial injection of botulinum toxin type A (Dysport) for tension type headache: a multicentre, double-blind, randomized, placebo-controlled study. Eur J Neurol. 2008;15:205–13.

    Article  PubMed  CAS  Google Scholar 

  104. Hamdy S, Samir H, El-Sayed M, et al. Botulinum toxin: could it be an effective treatment for chronic tension-type headache? J Headache Pain. 2009;10:27–34.

    Article  PubMed  CAS  Google Scholar 

  105. 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;26:790–800.

    Article  PubMed  CAS  Google Scholar 

  106. Karadas O, Gul H, Inan L. Lidocaine injection of pericranial myofascial trigger points in the treatment of frequent episodic tension-type headache. J Headache Pain. 2013;14:44.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  107. Fernández-de-las-Peñas C, Cleland J, Cuadrado M, Pareja J. Predictor variables for identifying patients with chronic tension-type headache who are likely to achieve short-term success with muscle trigger point therapy. Cephalalgia. 2008;28:264–75.

    Article  PubMed  Google Scholar 

  108. Sun Y, Gan T. Acupuncture for the management of chronic headache: a systematic review. Anesth Analg. 2008;107:2038–47.

    Article  PubMed  Google Scholar 

  109. Davis MA, Kononowech RW, Rolin SA, Spierings EL. Acupuncture for tension-type headache: a meta-analysis of randomized, controlled trials. J Pain. 2008;9:667–77.

    Article  PubMed  Google Scholar 

  110. 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. J Am Med Assoc. 2001;285(17):2208–15.

    Article  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  112. Torelli P, Jensen R, Olesen J. Physiotherapy for tension-type headache: a controlled study. Cephalalgia. 2004;24:29–36.

    Article  PubMed  CAS  Google Scholar 

  113. Van Ettekoven H, Lucas C. Efficacy of physiotherapy including a cranio-cervical training programme for tension-type headache: a randomized clinical trial. Cephalalgia. 2006;26:983–91.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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Ready, D.M., Dai, W., Keyser, L.K., Cabret-Aymat, C. (2019). Yogi’s Headache: Chronic Tension-Type Headache. In: Green, M., Cowan, R., Freitag, F. (eds) Chronic Headache. Springer, Cham. https://doi.org/10.1007/978-3-319-91491-6_5

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  • DOI: https://doi.org/10.1007/978-3-319-91491-6_5

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