Muscle-Contraction Headache Headache Classification Quickmenu Vascular Muscle-contraction Combined Nasal vasomotor reaction Delusional, hypochondriacal Nonmigrainous vascular Traction Cranial inflammation

• Definition
  Ache or sensations of tightness, pressure, or constriction widely varied in intensity, frequency, and duration. Sometimes long lasting and commonly suboccipital. It is associated with sustained contraction of the skeletal muscles in the absence of permanent structural change, usually as part of the individual's reaction during life stress.

• Cause
  Response to stressful situations or mechanical irritation of muscles, tendons, or fascia.

• Age of onset
  May start at any age.

• Prodrome
  None

• Headache

  description
  Bilateral tight band, pressure, vice-like pressure around the head. Usually located in the forehead, neck, shoulders, and all around the head. Severity varies. Usually not associated with nausea, vomiting, photophobia, or sonophobia. Depression commonly can present as tension headache. Headache of delusional, conversional, or hypochondric states may mimic a tension headache.

  frequency
  variable

  duration
  Few hours to several days.

  quality
  As above

  Treatment
  

  1. Identify the underlying cause of stress.
  2. Behavioral treatments: Biofeedback, psychotherapy, stress reduction, self management.
  3. Non-opioid analgesics. Opioid analgesic abuse occurs readily in these patients. Caffeine containing foods or medications may make headache worse.
  4. TENS, acupuncture, trigger point injections
  5. Tricyclic antidepressants

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