Infrequent Tension-type Headache Research Articles

Causes and Treatment of Tension Headache: A Review

Tension-type headache (TTH) is the most prevalent primary headache problem, affecting 46 percent to 78 percent of people at some point in their lives. However, the majority have episodic infrequent TTH (1 day per month or fewer) with no specific need for medical treatment. The diagnosis is made based on the patient's medical history and physical examination. The exact etiology of tension-type headache is unknown. The most likely cause of rare tension-type headaches is activation of hyperexcitable peripheral afferent neurons from head and neck muscles. Nondrug management is commonly utilized and should be considered for all patients with TTH. The scientific evidence for the efficacy of most treatment approaches, on the other hand, is limited. Pharmacological treatment depends on whether the headache is acute or chronic. In this review we will cover the disease epidemiology, etiology, diagnosis, and management.
 The aim is to study the Causes and Treatment of Tension Headache method a population-based study in Denmark, About 24% to 37% of the population experienced TTH several times a month, 10% had it weekly, and 2% to 3% of the population had chronic TTH,
 In contrast to migraine, women are only slightly more affected than males (the female-to-male ratio of TTH is 5:4), and onset is delayed (25 to 30 years). Between the ages of 30 and 39.

Prevalence of Tension-Type Headache among Medical Students in Tabuk University, Saudi Arabia

Background: Headaches disorders have a significant burden on the world. Tension Type Headache is the most common type among primary headaches. Since medical students are exposed to a lot of stress, and it is associated with a tension-type headache, the importance of this study comes. This study aims to measure the prevalence of tension-type headache among medical students at Tabuk University 2020.
 Methodology: A cross-sectional study in Tabuk, Saudi Arabia was conducted. The study included medical students at the University of Tabuk in the academic years from 2nd to 6th grades during the calendar year of 2020. An adapted semi-structured self-administered questionnaire was retrieved from other validated questionnaires. The internal validity and reliability of the questionnaire were tested using Cronbach's alpha test and was highly reliable (25 items, α = .715). Both medical and research experts assessed the face and content validity. The data were coded, tabulated, and analyzed using the Statistical Package for the Social Sciences (SPSS, version 27).
 Results: The total number of the students was 380 (response rate, 78.6%). 55.22% were females, and 44.78% were males their mean age was 21.18 ± SD 1.78 years. Out of the 297 students, only 122 met the diagnostic criteria. The 1-year prevalence Tension Type Headache (TTH) included the three types: frequent TTH 67.2%, 18.0% infrequent TTH, and only 14.8% suffered from chronic TTH. The most common aggravating factors included studying stressors (82%), 68% of the participants reported daily activity interference, and 48.4% reported that headache aggravate with routine physical activities (e.g., walking or climbing stairs). The headache quality varied between throbbing/pulsating (54.9%), pressing/tightening (68.9%) and sharp/stabbing (10.7%). The median headache intensity was 5.25 at pain level score (IQR =2). Only 28% of the students sought counseling where the main analgesic used was Acetaminophen (74%). Many non-pharmacological therapies were practiced by the students to relieve headache, including sleep (60.7%), rest (63.1%) and caffeine (41.8%).23% of the medical students reported that they sought medical counseling to maintain their performance level. There was a statistically significant difference between the average age of medical students suffering from frequent and infrequent TTH, t(102) = 2.31, p = .023.
 Conclusion: Tension-type headache is a prevalent type of headache among Saudi medical students. Prevalence and aggravating factors in our study were comparable to previously reported literature. Future studies with large sample size may be required among all university students to define burden of the case in Saudi Arabia.

Identifying Chinese Medicine Patterns of Tension-Type Headache and Understanding Its Subgroups.

Tension-type headache (TTH) is common among adults. Individualized management strategies are limited due to lack of understanding of subtypes of TTH. Chinese medicine (CM) uses the pattern differentiation approach to subtype all health conditions. There is, however, a lack of evidence-based information on CM patterns of TTH. This study aimed to identity common CM patterns of TTH. TTH sufferers were invited for a survey, consisting of a validated Chinese Medicine Headache Questionnaire (CMHQ), Migraine Disability Assessment Test, and Perceived Stress Scale. The CMHQ consisted of information about headache, aggravating and relieving factors, and accompanying symptoms. Principal component analysis was used for factor extraction and TwoStep cluster analyses for identifying clusters. ANOVA was used to compare cluster groups with disability and stress. In total, 170 eligible participants took part in the survey. The commonest headache features were continuous pain (64%); fixed location (74%); aggravated by overwork (74%), stress (74%), or mental strain (70%); and relieved by sleeping (78%). The commonest nonpain symptoms were fatigue (71%) and neck stiffness (70%). Four clusters, differing in their key signs and symptoms, could be assigned to three different CM patterns including ascendant hyperactivity of liver yang (cluster 1), dual qi and blood deficiency (cluster 2), liver depression forming fire (cluster 3), and an unlabelled group (cluster 4). Additionally, over 75% participants in clusters 1 and 2 have episodic TTH, over one-third participants in cluster 3 have chronic TTH, and a majority of participants in cluster 4 have infrequent TTH. The three patterns identified also differed in levels of disability and some elements of coping as measured with PSS. The three CM patterns identified are common clinical presentations of TTH. The new information will contribute to further understanding of the subtypes of TTH and guide the development of targeted intervention combinations for clinical practice and research.

Association of Hypothyroidism with Infrequent Tension-Type Headache

Background: Tension-type headache is a common neurological problem among general population of Bangladesh.
 Objective: This study was undertaken to ascertain the frequency of subclinical and over hypothyroidism in patients with infrequent TTH.
 Methodology: This study was conducted in a tertiary care hospital Dhaka medical college in Bangladesh. The study subjects consisted of 200 patients primary headache disorders. Thyroid function test were performed. All four sub-types of tension type headache were considered to include in the study, namely: Infrequent episodic (or infrequent), frequent episodic (or frequent), chronic sub-type and probable sub-type.
 Result: Forty percent (40%) patients in this study had infrequent TTH, 30% had frequent episodic TTH, 21% had chronic sub-type of TTH and 9% patients had probable sub-type of TTH. overt hypothyroidism. Among 46 patients with frequent episodic TTH 10 patients had subclinical hypothyroidism and 4 patients had overt hypothyroidism. Out of 18 patients with probable TTH 3 patients had subclinical hypothyroidism but no patient was overt hypothyroid. Out of 42 chronic TTH patients 12 had subclinical and another 12 had overt hypothyroidism. Statistically significant difference was seen among different sub-types of headache in relation to thyroid status.
 Conclusion: Hypothyroidism is found to be a co morbidity or precipitating factors to be development of infrequent type of tension-type headache.
 Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 60-64

Migraine and tension headache comorbidity with hypothyroidism in Egypt

BackgroundMigraine, tension type headache (TTH), and hypothyroidism are clinical problems that affect patient daily activities and quality of life.ObjectivesThe purpose of this study was to investigate the potential association between hypothyroidism in patients with migraine and TTH.Patients and methodsTwo hundred and twelve patients with migraine and TTH and one hundred control subjects underwent clinical evaluation, assessment of thyroid hormones, and thyroid ultrasound.ResultsSubclinical and overt hypothyroidism were significantly higher in patients with migraine and TTH (P = 0.001) than control subjects. Patients with migraine and TTH showed significantly more abnormal thyroid gland morphology than healthy control (P = 0.027). Hypothyroidism is significantly expressed in chronic TTH more than TTH with infrequent or frequent TTH (P = 0.009).ConclusionsPatients having migraine and TTH more prone to develop hypothyroidism when compared with control group. Also patients with chronic TTH are susceptible to develop hypothyroidism (either subclinical or overt) when compared with patients having frequent or infrequent TTH.

KORELASI KECEMASAN DENGAN JENIS TENSION TYPE HEADACHE PADA MAHASISWA KEDOKTERAN ANGKATAN 2019 DI UNIVERSITAS ANDALAS

<p><em>T</em><em>e</em><em>n</em><em>s</em><em>i</em><em>on type headache is the most common primary headache. Tension type headache can be triggered</em><em> by</em><em> anxiety. Anxiety often occurs in medical students, especially in new students. The aim of this study </em><em>was</em><em> </em><em>t</em><em>o determine the </em><em>correlation</em><em> between anxiety and tension-type headache among medical students batch 2019 in Andalas University.</em><em> </em><em>This </em><em>was an</em><em> </em><em>a</em><em>n</em><em>a</em><em>l</em><em>y</em><em>t</em><em>i</em><em>c study using cross-sectional</em><em> design</em><em>. Sampling was done by stratified random sampling technique and </em><em>we </em><em>obtained sample </em><em>from</em><em> </em><em>79 respondents. Headache diagnosis </em><em>was</em><em> based on the consensus of PERDOSSI 2018 which in accordance with International Classification of Headache Disorder 3<sup>rd</sup> Edition (Beta version). Anxiety </em><em>was</em><em> diagnosed by using</em><em> Hamilton Rating Scale for Anxiety questionnaire that had been validated. </em><em>The correlation </em><em>between variabels was analyzed using Spearman Rho test.</em><em> </em><em>T</em><em>h</em><em>e results of univariate analysis showed that the majority of respondent were women (69,6%). The </em><em>most common</em><em> </em><em>anxiety </em><em>category was</em><em> mild anxiety (57%). The most</em><em> common</em><em> </em><em>t</em><em>e</em><em>n</em><em>s</em><em>i</em><em>on-type headache</em><em> type</em><em> </em><em>was</em><em> </em><em>i</em><em>n</em><em>f</em><em>r</em><em>e</em><em>quent type (62%). The results of bivariate analysis showed 8 sample (34,8%) </em><em>which</em><em> </em><em>e</em><em>x</em><em>perienced moderate-severe anxiety had infrequent tension-type headache and 41 samples (73,2 %) </em><em>which </em><em>e</em><em>x</em><em>perienced mild anxiety also had infrequent tension type headache. This study showed that anxiety was positively correlated with tension-type headache (r=0,327 p=0.003)</em></p>

Prevalence and determinants of tension headache among medical students during their clinical years at King Abdulaziz University in Jeddah, 2019

Background: Tension-type headache (TTH) is the most common primary headache disorder among medical students. It affects academic performance and the quality of the student's daily lives. Objective: This study aimed to investigate the prevalence of TTH and associated factors among students at King Abdulaziz University (KAU) in Jeddah, Saudi Arabia. Methods: A cross-sectional study involved students at KAU in the academic years from 4th to 6th grades during the calendar year of 2019. For sampling purposes, we adopted a stratified proportional random sampling technique, and for data collection, we used a self-administered questionnaire. We defined TTH according to the diagnostic criteria in the third edition of the International Classification of Headache Disorders (ICHD-3b) from the International Headache Society (HIS). Results: A total of 387 medical students were approached, 50.1% were females, and 49.9% were males; their mean age was 22.8 ± SD 1.4. The lifetime TTH was 43.9%, and the 1-year prevalence TTH was 28.9%, these included both frequent TTH 25% and infrequent TTH 73%. Only 2% suffered from chronic TTH. Female sex was an unconfounded predictor for TTH, and sleeping for less than 8 hours/night was significantly associated with TTH (p Conclusion: tension-type headache is a common problem among medical students. It is highly recommended to provide a stress-free study environment, stress management courses, and relaxation programs. Keywords: Tension-type headache, Prevalence, Medical students, Saudi Arabia.

Primary headache characters and coping strategies among medical students of Umm Al-Qura University in the Western Region of Saudi Arabia.

Objectives:To assess the headache patterns among medical students of Umm Al-Qura College of Medicine, Makkah, Kingdom of Saudi Arabia. Medical students represent a vulnerable group for primary headache disorders, as they are exposed to various physical and psychological stressors.Methods:We carried an observational, cross-sectional study, and collected data during February, 2017 using electronic questionnaires. The international classification of headache disorders, third edition (ICHD-3) beta edition was used to classify headache into 10 types.Results:A total of 623 responses (82.2%) were received out of 758 participants. The one-year headache prevalence was 558 (89.6%). The most common diagnosis among both genders was frequent tension-type headache (TTH) (n=173, 31.0%), followed by probable infrequent TTH (n=114, 20.4%) and probable frequent TTH (n=63, 11.3%).The greatest proportions of students who reported an impact of their academic level were found among the chronic TTH, migraine without and with aura (n=2, 40.0%; n=14, 34.4%; n=11, 33.3%). Migraine without aura was more prevalent among females (n=29, 10.5%) than males (n=10, 3.5%). Self-medication was common (62.5%-100.0%). Simple analgesics (67.4%-80.0%), sleeping (54.3%-80.0%) and caffeine intake (28.3%-60.0%) were the top 3 therapies that were practiced.Conclusion:The prevalence of headache among Umm Al-Qura university (UQU), Makkah, Kingdom of Saudi Arabia’s medical students appears higher than the prevalence among the general population. This may have a significant impact on academic performance and necessitates special attention. We recommend further studies on interventions to reduce the prevalence and impact of this prevalent problem.

The PACE study: past-year prevalence of tension-type headache and its subtypes in Parma's adult general population.

The mean global prevalence of tension-type headache (TTH) in adult is 42%. To date, there have been no Italian studies on TTH prevalence in the adult general population. Therefore, we conducted a cross-sectional study, called PACE, aimed at detecting the prevalence of primary headaches in the city of Parma's adult general population. 904 subjects representative of Parma's adult general population were interviewed face to face by a physician of our Headache Centre. Crude past-year prevalence for definite TTH was 19.4% (95% CI 16.8-21.9; 18.4%, 95% CI 14.6-22.3 in men, and 20.1%, 95% CI 16.6-23.6 in women), namely, 9.0% (95% CI 7.1-10.8) for infrequent TTH, 9.8% (95% CI 7.9-11.8) for frequent TTH, and 0.6% (95% CI 0.1-1) for chronic TTH. Crude prevalence for probable TTH was 2.3% (95% CI 1.3-3.3; 2%, 95% CI 0.6-3.4 in men, and 2.6%, 95% CI 1.2-3.9 in women). Our results indicate a TTH prevalence (19.4%) at the lower limit of data ranges for Western countries, and prevalence rates for infrequent forms (9%) do not appear different from those of frequent forms (9.8%).

Prevalence of tension-type headache in adult general population: the PACE study and review of the literature

The mean global prevalence of tension-type headache (TTH) in adult is 42 %. To date, there have been no Italian studies on TTH prevalence in the adult general population. Therefore, we conducted a cross-sectional study, called PACE (PArma CEfalea, or "Headache in Parma"), aimed at detecting the prevalence and clinical features of primary headaches in the city of Parma's adult general population. Crude past-year prevalence for definite TTH was 19.4 % (95 % CI 16.8-21.9), namely 9.0 % (95 % CI 7.1-10.8) for infrequent TTH, 9.8 % (95 % CI 7.9-11.8) for frequent TTH, and 0.6 % (95 % CI 0.1-1) for chronic TTH. Crude prevalence for probable TTH was 2.3 % (95 % CI 1.3-3.3). Our study results indicate a TTH prevalence rate (19.4 %) at the lower limit of data ranges currently available for Western countries, and prevalence rates for infrequent forms (9 %) do not appear much different from those of frequent forms (9.8 %).

Secular Changes in Health Care Utilization and Work Absence for Migraine and Tension-type Headache: A Population Based Study

To assess changes in consultation rates, medication use and work absences due to migraine and tension-type headache (TTH) in Denmark over a 12-year period. Surveys of the general population in 1989 and 2001. Medical doctors conducted all headache diagnostic interviews based on ICDH-I and II. The participation rate was 76% (740) in 1989 and 74% (711) in 2001. Headache status was categorized as pure migraine, pure frequent TTH (frequent episodic or chronic TTH), coexisting migraine and frequent TTH, and healthy subjects (no primary headache or only infrequent TTH). Headache-related consultation rates (OR = 1.6 (1.1-2.2)), especially specialist consultations (OR = 3.6 (2.3-5.6)), increased for all headache groups. Use of prescription medication because of headache increased moderately (OR = 2.1 (1.1-3.9)) while the use of prophylactic medication was stable (OR = 1.1 (0.3-4.0)). Both headache-related (OR = 1.1 (0.7-1.7)) and overall (OR = 0.9 (0.7-1.2)) absence rates were largely unchanged. Headache-related absence rates were higher for subjects with both headache types (OR = 7.5 (4.3-13.1)) or with pure migraine (OR = 3.6 (2.0-6.6)) than for subjects with frequent TTH alone. Triptans users had higher migraine headache frequency and tended to have higher absence rates than non-users. Overall absence rates were higher for subjects with both headache types (OR = 2.3 (1.3-4.0)) or with frequent TTH (OR = 1.9 (1.4-2.7)) than for healthy subjects. Pure migraine was not associated with higher overall absence rates (OR = 1.0 (0.6-1.6)). Despite an increase in headache consultation rates and in use of prescription medication and triptans, no improvement in work absence rates was observed. Consultations, medication use, and absence rates were highest for individuals with both migraine and frequent TTH.

Tension–type headache in 40–year-olds: a Danish population–based sample of 4000

The aim of this study was to evaluate the one–year prevalence of tension–type headache in the general population. Three thousand men and one thousand women aged 40 years from the Danish population were included. They received a mailed questionnaire and the response rate was 87%. The selfreported one–year prevalence of tension– type headache was 84.7%. The one–year prevalence of infrequent episodic, frequent episodic and chronic tension–type headache was 48.2%, 33.8% and 2.3%, respectively. No tension–type headache and infrequent episodic tension–type headache was significantly more frequent in men than women (p<0.0005 and p=0.004), while frequent and chronic tension–type headache was significantly more frequent in women than men (p<0.0005 and p<0.0005). No tension– type headache and infrequent tension–type headache was significantly more frequent among those without than with self–reported migraine (no headache, men, p<0.0005 and women, p=0.002 and infrequent, men, p<0.0005 and women, p<0.0005), while episodic frequent and chronic tension–type headache was significantly more frequent among those with than those without self–reported migraine, with the exception of chronic tension–type in women (frequent episodic, men, p<0.0005 and women, p<0.0005 and chronic, men, p<0.0005 and women, p=0.08). Women are more prone to tensiontype headache than men and they have it more frequently than men. Self–reported migraine increases the risk for frequent episodic and chronic tension–type headache.