Epidemiology tension headache

Epidemiology tension headache

Tension headache Feeling of pressure in the head, soften frontal and sometimes occipital, often rising or radiating from the neck, not often presented to a part of the skull.
Incidence The annual incidence of tension type headache is 14.2 per 1000 person years. Decreases with age.3
Age 8th – 30th year of age

The average age of onset of TTH is higher than for migraine, namely between 25 and 30 years in cross-sectional epidemiological studies.6,7,8,11,12

Sex The male:female ratio for TTH is 4:5. Which means women are slightly more affected than men7,8,9
Pain location Head and neck
Symptoms Mostly bilateral, tight-pressing pain with an light to mediocre intensity which involves high muscle tension and triggerpoints.4,5
History of injury The risk factors for tension type headache include poor self-rated health, inability to relax after work, and sleeping for only a few hours per night.3
Provocation Pain is not triggered by movements of the neck and gives unilateral limitation of range of motion.4,5
Pathology Studies show that episodic tension-type headache is by far the most common primary headache disorder, affecting 40% of the population. Individuals with episodic tension-type headache may be at increased risk of developing chronic tension-type headache. This condition, although less common, affects 2.6% of females and 1.6% of males.2
Literature
  1. Jensen R. Diagnosis, epidemiology, and impact of tension-type headache. Curr Pain Headache Rep 2003;7:455–9.
  2. Saper JR, Silberstein SD, Gordon CD, Hamel RL, Swidan S. Handbook of Headache Management. 2nd ed. Philadelphia. Lippincott Williams & Wilkins; 1999.
  3. Lyngberg AC, Rasmussen BK, Jørgensen T, et al. Prognosis of migraine and tension-type headache. Neurology2005; 65:580-85.
  4. Orthopedic physical assessment, David J. Magee. Chapter 2 cervical spine, blz. 38
  5. 5. Orthopedic physical assessment, David J. Magee. Chapter 2 cervical spine, blz. 37
  6. Stovner L, Hagen K, Jensen R, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007; 27: 193–210.
  7. Zivadinov R, Willheim K, Jurjevic A, Sepic-Grahovac D, Bucuk M, Zorzon M. Prevalence of migraine in Croatia: a population-based survey. Headache 2001; 41: 805–12.
  8. 8. Lyngberg AC, Rasmussen BK, Jørgensen 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: 243–49.
  9. 9. Göbel H, Petersen-Braun M, Soyka D. The epidemiology ofheadache in Germany: a nationwide survey of a representative sample on the basis of the headache classifi cation of the International Headache Society. Cephalalgia 1994; 14: 97–106.
  10. Zwart JA, Dyb G, Holmen TL, et al. The prevalence of migraine and tension-type headaches among adolescents in Norway: The Nord- Trøndelag Health Study (Head-Hunt). Cephalagia 2004; 24: 373–79.
  11. 12. Rasmussen BK. Epidemiology of headache. Cephalalgia 2001;21: 774–77.

 

Diagnostics of different kinds of headaches:1,2

Cervicogenic hoofdpijn Migraine Tension headache
Unilateral pain: doesn’t change sides Unilateral pain, that can’t be bilateral and doesn’t change sides with different atacks. Mostly bilateral pain
Knocking pain Knocking pain Pressing tight pain
Mediocre to heavy intensity Mediocre to heavy intensity Light to Mediocre intensity
autonomic symptoms autonomic symptoms not associated with Autonomous symptoms
Pain that starts in the neck and is triggered by movements of the neck or / and by prolonged wrong posture Pain is not triggered by movements of the neck Pain is not triggered by movements of the neck
Common in women Common in men Common in women
Laying down feels better for the patient Is aggravated byroutine

physical therapy activities

Is not aggravated by routine physical therapy activities
Decreased ROM in the CWK No Decreased ROM in the CWK Unilateral ROM limitation in the CWK
No precipitant mechanism precipitant mechanism (food, light, stress) Not to allocate to other disorders
No response to medication Reaction on ergot / symatriptan, treatment Presence of triggerpoints; sensitivity to stretching of the shoulder / neck muscles and also in peri-cranial musculature
Good response to blockades of the cervical joints or nerves No response to blockades of the cervical joints or nerves blockade of the greater occipital reduces the pain the nerve not just only in the area of the blockage. Doesn’t stop the headache
Literature
  1. Orthopedic physical assessment, David J. Magee. Chapter 2 cervical spine, blz. 38
  2. Orthopedic physical assessment, David J. Magee. Chapter 2 cervical spine, blz. 37

 

 

 

 

 

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