Chronic tension-type headache: A new treatment experience
PDF (Español)
HTML (Español)

Keywords

Chronic Headache
Education
Steroids
Intramuscular Injection
Physiotherapy (MeSH)

Abstract

Introduction: the tension-type headache is the most common form of headache and chronic one of the most difficult to treat form, causes severe disability to patients and enormous socioeconomic costs is related to emotional stress factors and / or muscle. Therapeutic proposals, which are considered, include NSAIDs, physical therapy, injections of botulinum toxin in pericraneal muscles.

Objetives: to evaluate the effectiveness in the treatment of chronic tension-type headache with intramuscular infiltration with steroid betamethasone one deposit plus 1% lidocaine at points of muscle tension level sub-occipital, cervical paraspinal and trapezius, accompanied by physiotherapy, more an educational process to patients and families.

Materials and methods: retrospective study where treatment effectiveness was measured using the Visual Analogue Scale (VAS). Data were analyzed in SPSS using percentages, frequencies and proportions.

Results: total 138 cases of chronic daily headache tension type, mean age 51 years, 76.8% female, 21% is associated with anxiety disorder, 8.7% giddy feeling and 8.7% depressive symptoms, 8% type insomnia sleep disorders. 78.2% of patients reported improvement with the proposed treatment, of these, 85.5% of cases were quantified according to VAS, 66.8% showed improvement between 7 and 10 points; the highest percentage was asymptomatic for 3 months, 22.5% seizure-free for the total up of 7 months, 58.7% relapsed.

Conclusion: it is evident that the combination of intramuscular injections of lidocaine plus Betamethasone more Physiotherapy and a process of education of medical staff to patients and families, is an effective treatment without adverse effects in the management of chronic tension headache, considered one of the most difficult to treat.

https://doi.org/10.22379/2422402236

PDF (Español)
HTML (Español)

References

MORILLO LE, ALARCÓN F, ARANAGA N, ET AL. Prevalence of migraine in Latin America. Headache 2005;45:106-17.

JENSEN R, STOVNER L. Epidemiology and comorbidity of headache. Lancet Neurol. 2008;7:354-61.

BENDTSEN L, JENSEN R. Tension type headache: the most common, but also the most neglected headache disorder. Curr Opin Neurol 2006;19:305-9.

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.

BERG J, STOVNER LJ. Cost of migraine and other headaches in Europe. Eur J Neurol. 2005;12(Suppl 1):59-62.

BERG J. Economic evidence in migraine and other headaches: a review. Eur J Health Econom. 2004;5:S43-S54.

ANDLIN-SOBOCKI P, JONSSON B, WITTCHEN HU, OLESEN J. Cost of disorders of the brain in Europe. Eur J Neurol. 2005;12 (Suppl 1):1-27.

RASMUSSEN BK, JENSEN R, OLESEN J. Impact of headache on sickness absence and utilisation of medical services: a Danish population study. J Epidemiol Community Health 1992;46:443-6.

HEADACHE CLASSIFICATION COMMITTEE OF THE INTERNATIONAL HEADACHE SOCIETY (IHS) 2013. The International Classification of Headache Disorders, 3rd ed. (beta version) ICHD-3 beta. Cephalalgia 2013;33(9):629-808.

Volcy M. Cefalea tipo tensional: diagnóstico, fisiopatología y tratamiento. Acta Neurológica Colombiana 2008;24:S14-S27.

SARACCO MG, VALFRE W, CAVALLINI M, AGUGGIA M. Greater occipital nerve block in chronic migraine. Neurol Sci. 2010;31(Suppl 1):S179-S180.

GANTENBEIN AR, LUTZ NJ, RIEDERER F, SANDOR PS. Efficacy and safety of 121 injections of the greater occipital nerve in episodic and chronic cluster headache. International Headache Society 2012. Cephalalgia 2012;32(8):630-4.

BIONDI D. Physical treatments for headache: a structured review. Headache 2005;45:738-46.

HATCH JP, SCHOENFELD LS, BOUTROS NN, SELESHI E, MOORE PJ, CYR-PROVOST M. Anger and Hostility in Tension-Type Headache. Headache; 1991 May;31(5):302-4.

LOZANO C, ET AL. Eficacia de la terapia manual en el tratamiento de la cefalea tensional. Una revisión sistemática desde el año 2000 hasta el 2013. Neurología; 2014.

TORELLI P, JENSEN R, OLESEN J. Physiotherapy for tension-type headache: controlled study. Cephalalgia 2004;24:29-36.

ETTEKOVEN H VAN, LUCAS C. Efficacy of physiotherapy including a craniocervical training programme for tension-type headache: a randomized clinical trial. Cephalalgia 2006;26:983-91.

BARBANTI P, EGEO G, AURILIA C, FOFI L. Treatment of tension-type headache: from old myths. To modern Concepts. Neurol Sci. 2014;35(Suppl 1):S17-S2.

AMBROSINI A, VANDENHEEDE M, ROSSI P, ALOJ F, SAULI E, PIERELLI F, ET AL. Suboccipital injection with a mixture of rapid- and long-acting steroids in cluster headache: A double-blind placebo-controlled study. 2005 International Association for the Study of Pain. Published by Elsevier B.V.

SEMPERE AP, PORTA-ETESSAM J, MOLA S, MEDRANO V, GARCÍA-BARRAGÁN N, GARCÍA-MORALES I, ET AL. Utilidad de los estudios de neuroimagen en la evaluación de los pacientes con cefalea no aguda. Neurología 2002;17(9):449-93.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Downloads

Download data is not yet available.