Introduction:

Chronic Tension-Type Headache (CTTH) is a common headache disorder characterized by frequent tension-type headaches. Unlike episodic tension-type headaches, CTTH occurs on 15 or more days per month for at least three months. Understanding the nature, symptoms, diagnostic criteria, and treatment options for CTTH is essential for effective management and relief.

Characteristics and Risk Factors:

• CTTH is typically described as a mild to moderate, constant, band-like pain or pressure around the forehead, temples, and back of the head.
• Risk factors include stress, poor posture, eye strain, and other triggers similar to those of episodic tension-type headaches.
• There is often no identifiable organic cause, but muscle tension and stress play a significant role.

Symptoms:

• A dull, aching head pain.
• Sensation of tightness or pressure across the forehead or on the sides and back of the head.
• Scalp tenderness.
• Occasionally, muscle aches in the shoulders and neck.
• Unlike migraines, CTTH typically does not cause nausea, vomiting, or sensitivity to light and sound.

Diagnostic Evaluation:

• Diagnosis is primarily based on the patient's history and the characteristics of the headache.
• A headache diary can be helpful in documenting the frequency, duration, and characteristics of the headaches.
• Neurological examination to rule out other causes of headache.
• In some cases, imaging studies like CT scan or MRI may be performed to exclude other medical conditions.

Treatment and Management:

• Non-pharmacological treatments, such as relaxation techniques, stress management, and biofeedback, are often first-line therapies.
• Physical therapy, including exercises to improve posture and relieve muscle tension.
• Pharmacological treatments include pain relievers like NSAIDs or acetaminophen. Care must be taken to avoid medication overuse, which can lead to rebound headaches.
• Tricyclic antidepressants, such as amitriptyline, are sometimes prescribed for their pain-relieving properties.
• Lifestyle modifications, including regular physical activity and adequate sleep.

Complications:

• Chronic daily headaches can impair quality of life and lead to overuse of pain medication.
• Emotional and psychological effects, such as depression or anxiety, due to persistent pain.

Prevention and Patient Education:

• Education about headache triggers and effective stress management strategies.
• Encouraging regular exercise, healthy eating habits, and maintaining a regular sleep schedule.
• Importance of following the prescribed treatment plan and avoiding overuse of pain medications.

Conclusion:

Chronic Tension-Type Headache requires a comprehensive approach to management, including both pharmacological and non-pharmacological strategies. Understanding and addressing the individual patient's triggers and lifestyle factors are key to effective treatment and reduction of headache frequency and severity.

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