tension-type headache

緊張型頭痛

WordNet

1. write by means of a keyboard with types; "type the acceptance letter, please" (同)typewrite
2. a small metal block bearing a raised character on one end; produces a printed character when inked and pressed on paper; "he dropped a case of type, so they made him pick them up"
3. (biology) the taxonomic group whose characteristics are used to define the next higher taxon
4. a subdivision of a particular kind of thing; "what type of sculpture do you prefer?"
5. all of the tokens of the same symbol; "the word `element contains five different types of character"
6. printed characters; "small type is hard to read"
7. identify as belonging to a certain type; "Such people can practically be typed" (同)typecast
8. (psychology) a state of mental or emotional strain or suspense; "he suffered from fatigue and emotional tension"; "stress is a vasoconstrictor" (同)tenseness, stress
9. the physical condition of being stretched or strained; "it places great tension on the leg muscles"; "he could feel the tenseness of her body" (同)tensity, tenseness, tautness
10. (physics) a stress that produces an elongation of an elastic physical body; "the direction of maximum tension moves asymptotically toward the direction of the shear"
11. a balance between and interplay of opposing elements or tendencies (especially in art or literature); "there is a tension created between narrative time and movie time"; "there is a tension between these approaches to understanding history"
12. the action of stretching something tight; "tension holds the belt in the pulleys"
13. pain in the head caused by dilation of cerebral arteries or muscle contractions or a reaction to drugs (同)head ache, cephalalgia
14. writing done with a typewriter (同)typewriting

PrepTutorEJDIC

1. 〈C〉(…の)『型』,タイプ,類型,種類(kind)《+of+名》 / 〈C〉(その種類の特質を最もよく表している)『典型』,手本,模範《+of+名》 / 〈U〉《集合的に》活字;〈C〉(1個の)活字 / 〈U〉(印刷された)字体,活字 / 〈C〉(貨幣・メダルなどの)模様,図柄 / 〈C〉血液型(blood group) / …‘を'タイプに打つ / (…として)…‘を'分類する《+名+as+名(doing)》 / …‘の'型を決める / タイプライターを打つ
2. 〈U〉『ぴんと張ること』,伸長;ぴんと張った状態,張り / 〈U〉(精神的・感情的)『緊張』 / 〈C〉《複数形で》(一般に)『緊張状態(関係)』 / 〈U〉張力,引っ張る力 / 〈U〉起電力;電圧(voltage)
3. 『頭痛』 / 《話》悩みの種

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/31 07:03:35」(JST)

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Contributors

Tension headache
Classification and external resources
A woman experiencing a tension headache
ICD-10	G44.2
ICD-9	307.81, 339.1
DiseasesDB	12554
MedlinePlus	000797
eMedicine	article/1142908
MeSH	D018781

A tension headache (renamed a tension-type headache by the International Headache Society in 1988) is the most common type of primary headache. The pain can radiate from the lower back of the head, the neck, eyes, or other muscle groups in the body. Tension-type headaches account for nearly 90% of all headaches.

A number of medications have been found to be useful for prevention, including tricyclics and SSRIs. Evidence is poor for propranolol and muscle relaxants.

Tension headaches affect about 1.4 billion people (20.8% of the population) and are more common in women than men (23% to 18% respectively).

Signs and symptoms

Tension-type headache pain is often described as a constant pressure, as if the head were being squeezed in a vise. The pain is frequently present on both sides of the head at the same time. Tension-type headache pain is typically mild to moderate, but may be severe.

Frequency and duration

Tension-type headaches can be episodic or chronic. Episodic tension-type headaches are defined as tension-type headaches occurring fewer than 15 days a month, whereas chronic tension headaches occur 15 days or more a month for at least 6 months. Tension-type headaches can last from minutes to days, months or even years, though a typical tension headache lasts 4–6 hours.

Cause

Various precipitating factors may cause tension-type headaches in susceptible individuals:

• Stress: usually occurs in the afternoon after long stressful work hours or after an exam
• Sleep deprivation
• Uncomfortable stressful position and/or bad posture
• Irregular meal time (hunger)
• Eyestrain

One half of patients with tension-type headaches identify stress or hunger as a precipitating factor.

Tension-type headaches may be caused by muscle tension around the head and neck. One of the theories says that the main cause for tension-type headaches and migraine is teeth clenching which causes a chronic contraction of the temporalis muscle.

Another theory is that the pain may be caused by a malfunctioning pain filter which is located in the brain stem. The view is that the brain misinterprets information—for example from the temporal muscle or other muscles—and interprets this signal as pain. One of the main neurotransmitters that is probably involved is serotonin. Evidence for this theory comes from the fact that chronic tension-type headaches may be successfully treated with certain antidepressants such as amitriptyline. However, the analgesic effect of amitriptyline in chronic tension-type headache is not solely due to serotonin reuptake inhibition, and likely other mechanisms are involved. Recent studies of nitric oxide (NO) mechanisms suggest that NO may play a key role in the pathophysiology of CTTH. The sensitization of pain pathways may be caused by or associated with activation of nitric oxide synthase (NOS) and the generation of NO. Patients with chronic tension-type headache have increased muscle and skin pain sensitivity, demonstrated by low mechanical, thermal and electrical pain thresholds. Hyperexcitability of central nociceptive neurons (in trigeminal spinal nucleus, thalamus, and cerebral cortex) is believed to be involved in the pathophysiology of chronic tension-type headache. Recent evidence for generalized increased pain sensitivity or hyperalgesia in CTTH strongly suggests that pain processing in the central nervous system is abnormal in this primary headache disorder. Moreover, a dysfunction in pain inhibitory systems may also play a role in the pathophysiology of chronic tension-type headache.

Prevention

Tricyclics have been found to be more effective than SSRIs but have greater side effects. Evidence is insufficient for the use of propranolol and muscle relaxants for prevention of tension headaches.

Treatment

Medications

Episodic tension-type headaches generally respond well to over-the-counter analgesics such as ibuprofen, paracetamol/acetaminophen, and aspirin. Analgesic/sedative combinations are widely used (e.g., analgesic/antihistamine combinations like Syndol, Mersyndol and Percogesic, analgesic/barbiturate combinations such as Fiorinal). Frequent use of analgesics may, however, lead to medication overuse headache. The first-line treatment for chronic tension type headache is amitriptyline, whereas mirtazapine and venlafaxine are second-line treatment options. Other medication options include topiramate and sodium valproate (as prophylaxis). Biofeedback techniques may also help.

When all other treatment options have failed and pain is at a completely intolerable level, barbiturate medications such as fioricet and fiorinal may be prescribed as a drug of last resort. For this purpose, it is generally written as a single dose or one-two days worth of doses (once every 6 hours) until the pain stops. Although it is occasionally written in larger doses for use on a pro re nata basis this practice is discouraged due to the very high abuse potential, large range of interactions, and exceptionally high toxicity of the barbiturate class of drugs.

Botulinum toxin is a treatment trialled by some people with tension-type headache, though results are varied.

Acupuncture

Acupuncture may be useful in those with frequent or chronic tension headaches.

Manual therapy

People with tension-type headache often use spinal manipulation, soft tissue therapy, and myofascial trigger point treatment. A 2006 systematic review found no rigorous evidence supporting manual therapies for tension headache. A 2005 structured review found only weak evidence for the effectiveness of chiropractic manipulation for tension headache, and that it was probably more effective for tension headache than for migraine. A 2004 Cochrane review found that spinal manipulation may be effective for migraine and tension headache, and that spinal manipulation and neck exercises may be effective for cervicogenic headache. Two other systematic reviews published between 2000 and May 2005 did not find conclusive evidence in favor of spinal manipulation.

Epidemiology

Tension headaches affect about 1.4 billion people (20.8% of the population) and are more common in women than men (23% to 18% respectively).

Prognosis

Tension headaches that do not occur as a symptom of another condition may be painful, but are not harmful. It is usually possible to receive relief through treatment. Tension headaches that occur as a symptom of another condition are usually relieved when the underlying condition is treated. Frequent use of pain medications in patients with tension-type headache may lead to the development of medication overuse headache or rebound headache.

References

External links

• American Council for Headache Education
• National Headache Foundation
• World Headache Alliance

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 成人における緊張型頭痛：急性期治療 tension type headache in adults acute treatment
• 2. 成人における緊張型頭痛：病態生理、臨床的特徴、および診断 tension type headache in adults pathophysiology clinical features and diagnosis
• 3. 成人における緊張型頭痛：予防的治療 tension type headache in adults preventive treatment
• 4. 小児における緊張型頭痛 tension type headache in children
• 5. 慢性連日性頭痛の概要 overview of chronic daily headache

English Journal

• Prevalence of primary headache disorders in a population aged 60 years and older in a rural area of Northern China.

• Zhang Y1,2, Shi Z1,2, Hock D3, Yue W1,2, Liu S1,2, Zhang Y1,2, Liu S1,2, Zhao L1,2, Lu H1,2, Guan Y1,2, Wang X1,2, Wsiniewski T4, Ji Y5,6.
• The journal of headache and pain.J Headache Pain.2016 Dec;17(1):83. doi: 10.1186/s10194-016-0672-3. Epub 2016 Sep 13.
• BACKGROUND: Primary headache disorders are among the most common neurological complaints worldwide, and are significant causes of disability. Data are limited on the prevalence of primary headaches among individuals aged 60 years and older in China. The purpose of our study was to investigate the p
• PMID 27619363

• ATP-sensitive muscle afferents activate spinal trigeminal neurons with meningeal afferent input in rat - pathophysiological implications for tension-type headache.

• Nöbel M1, Feistel S1, Ellrich J1,2, Messlinger K3.
• The journal of headache and pain.J Headache Pain.2016 Dec;17(1):75. doi: 10.1186/s10194-016-0668-z. Epub 2016 Aug 26.
• BACKGROUND: Tension-type headache and other primary headaches may be triggered or aggravated by disorders of pericranial muscles, which is possibly due to convergent or collateral afferent input from meningeal and muscular receptive areas. In rodent models high extracellular concentrations of ATP ca
• PMID 27565510

• Headache yesterday in Karnataka state, India: prevalence, impact and cost.

• Steiner TJ1,2, Rao GN3, Kulkarni GB4, Gururaj G3, Stovner LJ5,6.
• The journal of headache and pain.J Headache Pain.2016 Dec;17(1):74. doi: 10.1186/s10194-016-0669-y. Epub 2016 Aug 25.
• BACKGROUND: The Global Campaign against Headache has pioneered evaluation of the prevalence and impact of headache on the preceding day ("headache yesterday") as a new approach to the estimation of headache-attributed burden, avoiding recall error. We report its application in Karnataka State, south
• PMID 27562856

Japanese Journal

• 病気について知りたい! 臨床講座(78)頭痛

• Pharma tribune : なりたい薬剤師になる! 7(6), 6-16, 2015-06
• NAID 40020512608

• 緊張型頭痛における頭痛の強さと急性増悪の日内変動 : ecological momentary assessmentによる検討(英文誌から)

• 心身医学 55(3), 277, 2015-03-01
• NAID 110009917695

• Amygdala Response During Anticipatory Anxiety in Patients with Tension-type Headache

• Showa Univ J Med Sci 27(1), 39-48, 2015-03
• NAID 120005673808

Related Pictures

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★リンクテーブル★

リンク元	「緊張型頭痛」
関連記事	「type」「typed」「typing」

「緊張型頭痛」

　　[★]

英

tension-type headache, tension headache

同

筋収縮性頭痛、筋緊張性頭痛、緊張性頭痛、筋緊張型頭痛、muscle contraction headache MCH

関

頭痛

[show details]

緊張型頭痛 : 約 426,000 件
筋収縮性頭痛 : 約 10,400 件
筋緊張性頭痛 : 約 30,000 件
緊張性頭痛 : 約 170,000 件
筋緊張型頭痛 : 約 166,000 件

頻度

• 慢性頭痛の中で最も多い
• 夕方に認められる頭痛に多い。

家族歴

• ほとんどない(少ない)

男女比

• なし(やや女性が多いか)

持続時間

• 長期間にわたることがある。

性状

• 鈍痛、軽度から中等度
• 頭を締めつけられる、または押さえつけられる感じ

• 1. 深部の絞めつけられるような感じ(絞扼感)
• 2. 帽子をかぶったような感じ(被帽感)
• 3. あるいは頭頂部の圧迫感

部位

• 頭部全般(後頭部に強い)
• 両側性が多いが、片側性もありうる(1/3を占める)

日常動作の影響

• 臥床することはない

随伴症状

• 後頭部～項部の筋肉に凝り、持続的な収縮を伴う(ことがある)。後頭筋・側頭筋・項筋群に限局性の硬結や圧痛　←　いわゆる肩が凝る
• 悪心・嘔吐はなし
• 光過敏・音過敏はあってもいずれか1つ

増悪因子

• (日常生活動作で増悪しない)

誘因

• 運動不足、一定姿勢の保持(筋性ストレス、うつむき姿勢)、精神的ストレス・心理社会的ストレス・心的緊張、抑うつ、眼精疲労、頚椎異常、咬合不全、頭痛薬の過剰摂取

診断基準

国際頭痛分類第2版における緊張型頭痛の診断基準

• A 〈2.1　稀発反復性緊張型頭痛は、1ヵ月に1日未満の頻度で生じる頭痛〉

• 〈2.2　頻発反復性緊張型頭痛は、1ヵ月に1日以上、15日未満の頻度生じる頭痛〉
• 〈2.3　慢性緊張型頭痛は、1ヵ月に15日以上の頻度生じる頭痛〉

• B 頭痛は30分～7日間持続する
• C 頭痛は以下の特徴の少なくとも2項目を満たす

• 1 両側性
• 2 性状は圧迫感または締め付け感（非拍動性）
• 3 強さは軽度～中等度
• 4 歩行や階段の昇降のような日常的な動作により増悪しない

• D 以下の両方を満たす

• 1 悪心や嘔吐はない（食欲不振を伴うことはある）
• 2 光過敏や音過敏はあってもどちらか一方のみ

• E その他の疾患によらない

緊張型頭痛の診断基準をひとつだけ満たさず、かつ片頭痛でないものは、〈2.4　緊張型頭痛の疑い〉に分類されます。

治療

• 方針：原因となるストレスの除去、対症療法。

方法

• 生活習慣の改善
• 運動療法　　運動のほか休養やマッサージもありうる
• 心理療法　　ストレスや不安の除去を促す
• 薬物療法

• NSAID
• NSAID+カフェイン
• 抗うつ薬
• 筋弛緩薬　　筋のストレスを除去
• 抗不安薬

参考

• 慢性頭痛　日本頭痛学会編／一般・GL（06年）／ガイドライン　緊張型頭痛はどのように分類し、診断されるのですか

http://minds.jcqhc.or.jp/stc/0025/3/0025_G0000155_0037.html

「type」

　　[★]

• n.

• 型、タイプ、(生物)タイプ標本

(windows)ファイル内容表示(linux -> cat])

ex. type report_20111118.jp.htm | php a.php > report_20111118.jp.jp.jp.html

関

form、mode、pattern、type specimen、typed

　 　 　 　 　 　 　 　

「typed」

　　[★]

• adj.

• 型の

関

form、mode、pattern、type

「typing」

　　[★]

• n.

• タイプで打つこと、タイピング。分類