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Tension headache: symptoms and treatment, diagnosis, prevention

Of course, tension headache (hereinafter referred to as HDN) is the most common form of headache. During the course of human life, its distribution in a population can fluctuate significantly, from 30 to 80%.

HDN is a form of primary headache that occurs so often that its spread can have significant socioeconomic consequences.

With the diagnosis of tension headache, there is a "headache." This pun is not superfluous, as according to modern concepts, one person can simultaneously have several types of headaches, for example, a migraine, which develops on the background of HDN. Therefore, we consider the difference between HDN and other types of cephalgia, how it manifests itself and how it is treated.


What is HDN and why does it occur?

Tension headache

Medicine has long been approaching this type of pain. But the problem turned out to be quite broad, and, moreover, it had such widespread and vague diagnostic criteria that even the term “tension headache” did not appear immediately. So, earlier the following variants of the name were used:

  • muscle tension headache;
  • psychomiogenic headache;
  • stressful cephalgia;
  • idiopathic cephalgia.

It is clear from these names that stress and muscular - tonic tension play an important role in the development of headache.

The modern definition is: tension headache is a primary (that is, not symptomatic) bilateral diffuse cephalgia of low or moderate intensity, which is compressive in nature.

The tension headache has an ICD code 10 - G 44.2. This suggests that HDN is listed in the neurological diseases section, but with the same success it could be included in the M section - diseases of the musculoskeletal system.

About the causes

Cause tension headache

Very simple with meningitis : inflammation of the lining of the brain causes a headache. Just with a migraine: vasodilation causes pulsating cephalgia. But HDN resembles a ball, from which several threads stick out at once. The causes of this pain are complex, and by value they can be distributed, for example, as follows:

  • Chronic psycho-emotional stress;
  • Anxiety and depression;
  • Chronic muscle stress is a condition in neurology called myofascial-tonic muscle syndrome. The condition provokes oxygen starvation of the muscles and gives rise to pain impulses in them. In this case, we are talking about the muscles of the neck, oculomotor muscles and internal muscles of the eye, shoulder girdle, as well as the frontal and occipital muscles separated by the aponeurosis of the skull.

That is why HDN is a disease of people of mental labor and office workers.

  • drug abuse. Bitter irony is that too zealous use of analgesics to relieve headaches causes the effect of "boomerang", and cephalgic syndrome only increases.

Of course, HDN is realized and triggered only by the interaction of all factors that can play different roles in the etiology of this disease.

There is the following separation of types of tension-type headaches:

  1. Infrequent episodic form. Attacks last from half an hour to several days. Pain can be combined with tension in the neck and neck muscles;
  2. Frequent, but episodic form. Attacks, no matter how often they occur, still take less time than bright gaps;
  3. Chronic HDN. In this type of disease, the head hurts more often than it does not hurt: in each month it lasts more than 15 days, and it lasts at least 3 months a year. Chronic tension headache is the “life partner” of the patient, which greatly impairs its quality.

Symptoms of tension headache

Symptoms of tension headache Symptoms of tension headache are quite clearly stated in diagnostic criteria. They are so simple that everyone who suffers from a headache can “try them on himself”:

  • Pain always arises from two sides. This may be asymmetrical pain: on the one hand, the sensation is more pronounced, on the other, less. But one-sided localization is uncharacteristic;
  • The nature of pain is always compressing, pressing. At the same time, the pain never pulsates. Many people figuratively compare pain with a “helmet” or “hoop”;
  • Cephalgia intensity is low or moderate. Strong, as in meningitis, neuralgia or migraine, this pain does not happen;
  • Possible pain pericranial muscles (cervical, occipital) on palpation;
  • An important symptom of tension headache is the absence of increased pain during physical exertion: it is “even” - running, walking up the stairs do not affect its intensity;
  • With HDN, nausea or vomiting never occurs. In extreme cases, a bright light may be unpleasant, or a loud sound, but just one of these.

The frequency of this pain in different age groups is about the same: in young people and the elderly. A person gradually gets used to this pain and sometimes does not even notice her presence.

Examination of HDN

HDN has no particular morphological substrate. This means that it is impossible to perform, say, an MRI scan of the brain and point with a finger: "here he is - the source of tension headaches!"

Even with chronic cephalgia, no focal symptoms will be found. Therefore, the diagnosis of HDN is made on the basis of the following methods:

  • questioning and careful collection of anamnesis (primarily medicinal and allergic), including questions about the regimen, bad habits, type of activity;
  • general and neurological examination;
  • palpation of the muscles of the neck and neck, the definition of painful points.

And in order to ascertain whether cephalgia is symptomatic, that is, whether it is caused by some chronic disease (for example, drug addiction, hepatitis or cerebral arterial hypertension), such methods as ultrasound, CT, MRI, general (routine) blood and urine tests and other methods at the discretion of the attending physician.

Headache tension treatment

Headache tension treatment

Often patients, exhausted by a long, exhausting attack of cephalgia, are looking for ways to relieve tension headaches. Most often, it is a pill potent. For some time, the pain subsides, but then she again "comes into her own right." Then the drugs completely cease to act ...

The fact is that the treatment of tension headaches is a long process, which requires the interaction of a doctor and a patient. And to begin, after an establishment of the diagnosis, it is necessary with not medicinal actions:

  • You need to sleep at least 8 hours a day, do not train yourself to go to sleep at the same time. The sleeping room should be ventilated, the bed should be comfortable. It is necessary to get an orthopedic pillow, and even a mattress, so that after sleep the patient feels rested;
  • Special attention should be paid to nutrition. It is possible that headache, weak mood, associated with improper diet, chronic constipation and autointoxication. You need to eat more vegetables, fruits, fiber, seafood, herbs, cereals. It is advisable to drink more clean water, to teach to empty the intestines at the same time, and sit down at the table hungry. All refined products, canned goods, sausages, smoked meats, fast food, fatty foods are excluded from the diet;
  • It is strictly forbidden to coffee, spirits and beer, as well as to try to give up cigarettes and their substitutes. Even electronic cigarettes contain nicotine, which is a carcinogen;
  • You need to revise your mode, in relation to activity and stationary work. Need to be interrupted for charging or active leisure every 2 hours, if the work is related to mental activity;
  • You need to find your type of outdoor activities: hiking in the woods, biking, swimming. All the activity that causes the muscles of the neck, neck, arms, to experience stress, will be useful. In this case, all the lactic acid accumulated during the day will leave the muscles, and they will no longer be in a state of chronic spasm;
  • Water procedures are shown: warm relaxing baths, morning douche. If there are no contraindications, you can visit the bath for a short time, “until the first sweat”. This will contribute to the release of toxins and the overall improvement of the body;
  • Respiratory gymnastics, auto-training sessions, relaxation;
  • Massage and manual therapy. Sometimes a well-conducted massage course alone makes the patient forget about a headache. But the massage should be done professionally: the patient should not be hurt or unpleasant during the execution of the massage, and after the procedure there should be a pleasant relaxation, you can even sleep for half an hour. Shown is a back and neck - neck area massage.

stress headache pills

In the event that non-drug methods are unable to completely cope with the pain or it takes a longer time, then tablets for tension headache and drugs for the relief of symptoms are introduced into the treatment:

  • Nonsteroidal anti-inflammatory drugs with analgesic and anti-inflammatory effects. The most powerful tool is "Ketanov", but they should not be abused. Aspirin, ibuprofen, paracetamol are used more often. These are such drugs as "Nurofen", "Bonifen". Helps ketoprofen ("Ketonal"), lornoksikam ("Ksefokam"), "Movalis."

These drugs are important not to take a long time, not more than 2-3 days. More frequent use can increase headache, as well as cause heartburn and exacerbation of erosive and ulcerative processes in the stomach and intestines.

Therefore, according to indications, if the patient has an ulcer history, then it is necessary to combine the intake of NSAIDs with omeprazole.

  • In the case of pronounced muscular tension, muscle relaxants of the central action (“Mydocalm”, “Sirdalud”) are used, it is possible in the form of intramuscular injections. Their use allows you to break the "strong circle" and remove the muscle component from the pathogenesis of HDN;
  • With such complaints, which speak of a lack of attention, distraction, inability to coordinate at work, the use of nootropic drugs is shown: Phenibut, Pantogam, Semax. Even the usual "Glycine" can be taken at night, dissolving 2 tablets at once. This drug improves the inhibitory processes in the cerebral cortex, and makes it easy to fall asleep;
  • Multivitamin preparations and vitamins of the neurotropic nature have a good effect - group "B". These include "Milgamma."
  • Almost always, it is not forbidden to take soft herbal preparations with anti-anxiety and sedative effects, especially in order to improve sleep: “Fito-sedan”, “Corvalol”, “Novo-passit” and other means.

But, sometimes, the depressive and anxious component is so pronounced that treatment of chronic tension headaches begins with antidepressants.

Amitriptilin was previously prescribed, but, given the side effects of long-term use of tricyclic antidepressants, the appointment of SSRIs (Rexetin, Paxil, Prozac, Zoloft) is indicated.

These remedies are well proven in complex therapy in the treatment of chronic tension headache. Antidepressants such as Coaxil (tianeptin) and Lerivon (mianserin) are also used. Their task is to eliminate the psycho-vegetative component for 2 months, improve mood, reduce fear and anxiety.

Of course, in the treatment of tension headaches, when the patient turned for the first time, you need to start all the activities at once: antidepressants, muscle relaxants, massage, giving up bad habits.


The tension headache, the symptoms and treatment of which we have tried to describe, comes very unnoticed. Often the debut of HDN occurs in students, during sessions, coursework, exams. So a person gets into her captivity, from which he tries to get out with pills and stimulants.

It must be remembered that gardeners and landscape designers, flower growers and fishermen very rarely diagnosed with HDN. Therefore, for preventive purposes, it is necessary to dose the visual and mental stress, move more, eat moderately and eat with appetite, sleep well.

This lifestyle will replace the very best antidepressants.


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