Tension Type Headache: What is it and what is the role of physiotherapy

What is Tension Type Headache

Tension Type Headache (TTH), also defined as tension type headache, is the most common type of headache in humans. This is a type of primary headache, which means it is a disease in itself and is not a symptom of another disease. TTH can attack anyone, both men and women, and can affect all ages, although it is more common in adults.

Symptom Tension Type Headache

1. Headache
   • Usually the pain is dull and the pressure is felt on both sides of the head, although it can also be on one side. The pain is usually mild to moderate but can last a long time, from several hours to several days.

2. Feeling Tense
   • People who experience TTH often report feelings of tightness or stiffness in the neck, shoulders, and head.

3. There are no additional symptoms
   • TTH is not usually associated with other symptoms, such as nausea, vomiting, or sensitivity to light and noise, that are common in other types of headaches, such as migraines.

Causes of Tension Type Headache

Although the exact cause of TTH is not completely understood, several factors are believed to play a role in causing these headaches:

1. Physical and mental stress:
   • Stress can cause muscle tension in the neck and head which can trigger TTH.

2. Bad Posture:
   • Incorrect or bad posture, especially when sitting for a long time in front of a computer or looking at a smartphone screen, can cause muscle tension and TTH.

3. Lack of sleep:
   • Lack of sleep or poor quality sleep can cause muscle tension and headaches.

4. Dehydration:
   • Dehydration in the body can also trigger TTH in some people.

5. Genetic factors:
   • Several studies show that the tendency to experience TTH has a genetic link.

The Process of Occurring Tension Type Headache

The process by which tension-type headaches (TTH) develop is not completely understood, but there are several theories that attempt to explain the mechanisms that may be involved. TTH involves complex interactions between the central nervous system, head and neck muscles, and psychological factors. Below are several theories that are the basis for understanding the occurrence of TTH:

1. Brain Stimulus Sensitivity

TTH has been associated with changes in brain sensitivity. Several studies have shown that the central nervous system of TTH patients is more responsive to noxious stimuli, including painful stimuli in the head and neck muscles. This can cause feelings of pain and tension that are greater than necessary in response to normal stimulation.

2. Muscle Tension

Muscle tension in the neck, shoulders, and head is likely a major contributor to TTH. Some people may tend to feel increased muscle tension, especially in response to physical and mental stress. This muscle tension can cause pain in the head and neck area.

3. Blood Circulation

Some studies have shown that TTH may be associated with changes in cerebral blood flow. Reduced blood flow to the brain or changes in blood flow to the head and neck can trigger TTH in some people.

4. Psychological Factors

Psychological factors such as stress, anxiety, and depression have been linked to TTH. Stress and emotional tension can impair brain function and increase muscle tension, which in turn can lead to TTH.

5. Referral Pain

Some studies show that muscle tension in certain areas of the head and neck can cause pain in different areas. For example, muscle tension in the neck can cause pain in the eye area or forehead. This process is known as transfer pain.

Treatment Tension Type Headache

Treatment for TTH is aimed at relieving pain and eliminating symptoms. Following are some commonly used treatment methods:

1. Drugs

Analgesics such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help relieve mild to moderate TTH pain. For more severe headaches, your doctor may also prescribe stronger pain relievers or combination medications.

2. Physiotherapy

Exercises provided by a physiotherapist, such as stretching exercises, relaxation techniques and massage, can help relieve muscle tension and relieve headaches.

3. Stress management

Recognizing and reducing stress in daily life can help prevent or reduce the incidence of TTH.

4. Lifestyle Changes

Changing sleep patterns, proper posture, and exercise routines can help reduce the risk of TTH.

5. Counseling or Cognitive Behavioral Therapy

In some cases, counseling or behavioral therapy can help address the psychological factors associated with TTH.

The Role of Physiotherapy in Tension Type Headache Tension Type Headache

Physiotherapy plays an important role in the treatment oftension type headache (TTH). As a form of physical therapy, physiotherapy aims to relieve pain, improve muscle mobility and function, speed recovery, and prevent recurrent TTH. Here are some ways physiotherapy can help treat cases of TTH:

1. Stretching and relaxing muscles

A physiotherapist can help TTH patients do exercises to stretch tense head, neck and shoulder muscles. This stretch helps reduce muscle tension that can cause pain.

2. Massage and manual techniques

Physical therapists can use massage and manual mobilization techniques to relieve muscle tension and increase circulation in areas associated with TTH. These massages and manual techniques help release muscle tension that causes headaches.

3. Posture Exercises

Physical therapists can help patients increase postural awareness and correct poor posture, especially when poor posture contributes to TTH. Posture exercises help reduce stress on the muscles and joints in the neck and head.

4. Biofeedback

Biofeedback techniques use electronic devices to help patients become more aware of their body's response to stress and tension. This allows patients to learn to control their physical responses and reduce muscle tension that can trigger TTH.

5. Physical movement therapy

Physiotherapists can also design physical exercise programs tailored to the patient's needs and circumstances, which can help improve muscle strength, flexibility and overall body stability. Proper exercise can help prevent recurrent TTH.

6. Training and prevention planning

In addition to physical therapy, physiotherapists can also educate patients on how to manage stress, improve sleep quality, and adopt a healthier lifestyle. Prevention planning tailored to the patient's condition can also help reduce the risk of TTH recurrence.

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Reference :

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2. Repiso-Guardeño A, Moreno-Morales N, Armenta-Pendón MA, Rodríguez-Martínez MDC, Pino-Lozano R, Armenta-Peinado JA. Physical Therapy in Tension-Type Headache: A Systematic Review of Randomized Controlled Trials. Int J Environ Res Public Health. 2023 Mar 2;20(5):4466. doi: 10.3390/ijerph20054466. PMID: 36901475; PMCID: PMC10001815.
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