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to Expect? Glossary Background Nearly all of us have had a tension-type headache, but most of us believe we can handle it. We take an over-the-counter analgesic and before we know it, the headache has disappeared. Millions, however, encounter headaches that are so painful, debilitating or frequent that we seem to spend our days waiting for "it" to attack and then to retreat. As universal as tension-type headaches are, their causes and symptoms are more complicated and unique than you might realize. The word "tension" can be misleading, too, because not all headaches are caused by tension. In fact, many people do not seek medical attention when they should because they assume the cause of their head pain must be tension. Physicians describe two tension-type headaches: episodic and chronic. Episodic Generally, episodic headaches occur randomly and are often the result of temporary stress, anxiety, fatigue or anger. They are what most of us consider "tension-type" headaches. Symptoms include soreness in your temples, a tightening band-like sensation around your head (a "vice-like" ache), a pulling feeling, pressure sensations, and contracting head and neck muscles. This is why physicians may refer to tension-type headaches as "muscle contraction" headaches. Your symptoms can also include a tightness in your neck (as if your "head and neck were in a cast"); only certain positions seem to provide relief. The headache surfaces in your forehead, temples or the back of your head and neck. If you can ease or eliminate your headache by taking an over-the-counter (OTC) medication -which brings relief in about one to two hours -- then yours are probably episodic headaches. While you may have several of these tension-type headaches during a month, you are probably managing them yourself with an analgesic, a long walk or, if possible, a good night's sleep. If, however, you find that you are taking medication daily or almost daily, then you should see your physician because yours may be chronic tension-type headaches. Or, you may be experiencing rebound headaches, which are medication-induced and both aggravate and mask other headaches. Chronic A tension-type headache that occurs just about every day, and may have been going on for months, is chronic. It is the frequency that distinguishes episodic from chronic headaches. If you suffer from chronic headaches, you probably have not found much relief in over-the-counter medications for a pain that seems constant and unrelenting. That is why people who suffer from chronic headaches should ask their doctors for help. That is also why, when we discuss tension-type headaches here, we are referring to those that are chronic. Headache Types | TENSION-TYPE
. This prevalence among women. the fact remains: The chronic tension-type headache is generally the result of -. a tightening band around your head (a "vice-like" ache). but women do have a greater incidence of them. the pain is continuous. psychological issues. . and only certain positions seem to provide relief. and every personality type can experience them....not necessarily the cause of -.. or depression Chronic tension-type headaches affect both men and women.) ..either anxiety or depression. Thus. however.Your headache primarily occurs in your forehead.The muscles between your head and neck contract for hours or days... Headache Types | TENSION-TYPE Different Type of Headaches Headache Types Headache and Children How Do I Choose What to Expect? Glossary Symptoms Physical Symptoms The primary difference between episodic and chronic headaches is headache frequency and severity of some symptoms. but not throbbing. temples or the back of your head and/or neck... may be due to the fact that women seek medical help and report headaches more frequently than men... (A "stiff" neck might be symptomatic of a more serious disorder.. annoying. or pressure sensations.You may feel a soreness.. A pattern of chronic tension-type headaches generally begins between the ages of 20 and 40.You experience a tightness around your neck or even feel as if your head and neck were in a cast.For most of you.. your chronic headaches may feel like what we described for episodic headaches: . Physical Symptoms Associated with Anxiety or Depression Although many people do not easily or comfortably accept the notion that they could be depressed. a pulling. You may not even realize that you are . .Different Type of Headaches Headache Types Headache and Children How Do I Choose What to Expect? Glossary Chronic Tension-Type: Description Chronic tension-type headaches may be the result of stress or fatigue. but more than likely. they can be attributed to physical problems. .
or you may be sleeping excessively (hypersomnia).. and this is why a medical evaluation is so important.. most are the result of temporary anxiety or depression or a more pronounced depression. that these may also be symptoms of other diseases. If it is determined that the underlying source of your chronic tension-type headache is depression. the . Changes in sleep patterns If your headaches are related to anxiety.. Remember. or poor memory .. though. Physical and Environmental Causes Poor posture... Shortness of breath Constipation Nausea Weight loss Ongoing fatigue Decreased sexual drive Palpitations Dizziness Unexpected crying Menstrual changes .feeling anxious or are in a state of depression. indecisiveness. particularly cervical arthritis Abnormalities in neck muscles. for each person.. bones or discs Eye strain caused when one eye is compensating for another eye’s weakness Misalignment of teeth or jaws Noise or lighting While a physical problem can precipitate a chronic tension-type headache. you can find relief. no interest in life.... Emotional Symptoms Associated with Depression Many people who cope with chronic tension-type headaches associated with depression also describe other feelings and symptoms: Feelings of guilt Hopelessness Unworthiness Fear of mental or physical disease or death Poor concentration. awaken before you wanted to in the morning. Precipitating Factors Many things can contribute to a tension-type headache. or cramps from assuming an unnatural head or neck position for long periods of time Arthritis... And.. then you may have trouble falling asleep or you may suffer from insomnia. Early morning/late day occurrence. once you recognize the source of your emotional concerns. then you may also be experiencing one or more of the following symptoms. then you may awaken frequently during the night.. You may awaken to a headache or find it occurring just when you think you are leaving the stress behind. but. close work under poor lighting conditions. little ambition. If your headaches are associated with depression.
such as biofeedback or relaxation exercises. NSAIDs (Nonsteroidal Anti-inflammatory Agents) Fenoprofen Flurbiprofen Ketoprofen Naproxen Nabumetone Oxaprozine Antidepressants -. and learning self-help measures. and the effect they have on your job and lifestyle may be depressing you. avoiding or minimizing the causes. Emotional Factors Job Conflicts and Family Relationships You may be experiencing difficulties at work or in your personal life. you may believe you have adapted to a distressing or aggravating situation and are not totally aware of how much it has actually affected you. instead. Finally. and you should discuss them with your doctor.Tricyclics (sedating) Amitriptyline Doxepin . This can be diagnosed and managed through medical attention.and thus the headache -. despair or grief. Depression There are different types of depression and one of them is what physicians refer to as "reactive depression." For example.. Preventive Treatment/Chronic Headaches As you review these. You may be taking a medication and you did not realize that one of its side effects is depression... And. the actual illness itself.situation that induced or caused the depression -.may be different. the depression may not be the result of external events or medications and may. If your doctor suggests medications. Thus.. anxiety. be caused by an underlying psychological illness or biochemical depression... Your headache is alerting you to a problem that deserves medical attention. you may be coping with and reacting to a significant physical illness or disability. . you should realize that they may take several weeks to become effective and they can have side effects..Tricyclics (non-sedating) Protriptyline Desipramine Antidepressants -... Grief If someone close to you is ill or has died. remember that all medications have side effects. you must be patient and cooperate with your doctor to find the optimal treatment.... like many people.. Prevention includes taking prescribed medications. Grief frequently precipitates chronic headaches. the associated psychological feelings.. your headache may be related to sadness. Treatments There are two goals when treating any type of headache: prevent future attacks. abort or relieve current pain.
these are discussed separately after the next section on migraine headaches.Nortriptyline Imipramine Serotonin Reuptake Inhibitors These antidepressants act only on the neurotransmitter serotonin. a subject that is addressed in our Web Site section. Ibuprofen Diclofenac Ketorolac Flurbiprofen Meclofenate Muscle Relaxants/Analgesics Carisoprodol Orphenadrine citrate Chlorzoxazone Methocarbamol Cyclobenzaprine HCL Metaxalone Baclofen Other Isometheptene mucate-Dichloralphenazone-Acetaminophen combinations Self-Help Therapies: Chronic Tension-Type and Migraine Headaches Your doctor may suggest self-help measures for your headache. "Other Types of Headaches: Rebound. beyond the labeling instructions and doctor’s prescription. . Fluoxetine Sertraline Paroxetine Nefazodone Venlafazine Citalopram Escitalopram Others Trazodone Bupropion Phenelzine (MAOI — Monoamine Oxidase Inhibitor) Abortive Treatment/Chronic Headaches All over-the-counter and prescription medications can have side effects. Over-using medications." NSAIDs (Nonsteroidal Anti-inflammatory Agents). can lead to dependence and rebound headaches.
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