Chronic Tension Headache

Patients suffering from chronic tension headache have a significantly reduced quality of life due to their constant pain. Most importantly, they are at risk of developing medication-induced headaches, as well as anxiety disorders and depression, if the condition is not treated. Experts from the German Migraine and Headache Society therefore recommend that patients with chronic tension headaches undergo comprehensive therapy using various strategies, such as those offered in interdisciplinary treatment centers.

Chronic tension headache

In Germany, around three percent of the adult population, i.e. more than two million people, have chronic tension headaches, i.e. they suffer daily or almost daily from the dull-pressing or pulling headaches. If sufferers then combat their pain with analgesics, they run the risk of a medication-induced headache. This is because analgesics can cause headaches if they are taken too frequently.

In addition, the quality of life of patients is greatly reduced, as studies by American researchers have shown. Depression and anxiety can be the result. Patients with chronic tension headaches struggle to maintain their social and occupational functions, but they are tired, sleep poorly and feel depressed. In half of the total of 245 patients, the U.S. researchers therefore diagnosed depression requiring treatment.

German experts make similar observations: “More than 80 percent of all patients with tension headaches do not go to the doctor,” notes Günther Fritsche, a psychologist at the headache outpatient clinic of the neurological university hospital in Essen. “If initially only occasionally occurring tension headaches become chronic because they remain untreated, the affected persons therefore run the risk of developing an anxiety or depression disorder of psychiatric proportions in addition to their headaches.”

Therapy

Treatment of tension headaches focuses on nonpharmacologic treatment methods:

  • Progressive muscle relaxation according to Jacobson,
  • Stress management training,
  • Light physical activity, biofeedback and
  • Psychological-behavioral health strategies

Help patients “immunize” themselves against the internal and external stressors. Psychological-behavioral medicine methods also alleviate depression and anxiety.

In addition, preventive drug therapy can be helpful. Medications that are normally used to treat depression serve this purpose. This is because they also influence the processing of pain stimuli in the brain. Such comprehensive therapy procedures are offered in interdisciplinary headache centers and specialty practices. “Sufferers learn that they can develop ways and strategies to manage their pain. They find a way out of their social isolation, meet their friends again and attend movies or concerts,” Fritsche sums up the treatment results. The bundle of measures consisting of relaxation, exercise and behavioral therapy has the effect of raising the patients’ lowered pain threshold. In this way, it is possible to break the vicious circle of pain.