The role of pericranial muscles in the succesful management of episodic tension type headache

Abstract

Peripheral and central nociceptive mechanisms are responsible for the development of Tension Type Headache (TTH). Analgesics are frequently used in the treatment of acute TTH. Antidepressants are used in prevention. In this study, the therapeutic efficacy of local application of lidocaine was investigated in Episodic Tension Type Headache (ETTH) patients. ETTH patients with pericranial tenderness (n=20, Group 1) and without pericranial tenderness (n=20, Group 2) were included in our study. Three sessions of local injection of 1% lidocaine were performed in both groups. Two-sided intramuscular injections of 1 mL were applied for each patient. The muscles treated were the frontal, temporal, masseter, sternokloidomastoid, semispinalis capitis, splenius capitis and trapezius muscles. Patients were evaluated in 1st, 2nd, and 3rd months. The number of painful days per month and pain intensities were recorded according to Visual Analog Scale (VAS) before and after the treatment. 11 male and 29 female patients were included in the study. The mean ages of Group 1 and Group 2 were 35.95 ± 9.85 (18-53) and 34.85 ± 10.04 (20-54) years, respectively. There was no difference between the groups in terms of age, gender, pain frequency and pain intensity (p>0.05). The frequency and severity of pain was significantly lower in pericranial-sensitive ETTH patients at the 1st, 2nd, and 3rd months after local lidocaine injections compared to ETTH patients having pericranial tenderness (p<0.05). Local lidocaine application can be used as an effective method in the treatment of ETTH patients with pericranial tenderness.