Cephalic and extracephalic pressure pain thresholds in chronic tension-type headache

&NA; Pressure pain thresholds were assessed with an algometer (Sometic Inc.), over the forehead, temple and suboccipital region as well as over the Achilles tendon. A group of 32 patients suffering from chronic tension‐type headache was compared to 20 healthy controls and to 10 migraineurs without aura. Although individual values were widely scattered, pressure pain thresholds were on average significantly lower in chronic tension‐type headache, not only at pericranial sites but also over the Achilles tendon. Only 50% of these patients had one or more pericranial thresholds 1.5 S.D. below the mean of controls. After muscular biofeedback therapy, all pain thresholds were on average increased. Along with results obtained previously, the present data support the hypothesis that diffuse disruption of central pain‐modulating systems, possibly due to a modified limbic input to the brain‐stem, is pivotal in the pathophysiology of chronic tension‐type headache.

[1]  J. Olesen,et al.  Pericranial Tenderness in Tension Headache , 1985 .

[2]  J. Olesen,et al.  Clinical Characterization of Patients with Chronic Tension Headache , 1988, Headache.

[3]  J. Olesen,et al.  Pressure pain thresholds and thermal nociceptive thresholds in chronic tension-type headache , 1989, Pain.

[4]  P. Drummond.  Scalp Tenderness and Sensitivity to Pain in Migraine and Tension Headache , 1987, Headache.

[5]  D. Bakal.  The psychobiology of chronic headache , 1983 .

[6]  M. Feuerstein,et al.  Stress and chronic headache: a psychophysiological analysis of mechanisms. , 1982, Journal of psychosomatic research.

[7]  M. Langemark.  Naloxone in moderate dose does not aggravate chronic tension headache , 1989, Pain.

[8]  J. Olesen,et al.  Pericranial muscle tenderness and pressure-pain threshold in the temporal region during common migraine , 1988, Pain.

[9]  J. Travell.  Myofascial pain and dysfunction , 1983 .

[10]  J. Olesen,et al.  Evaluation of pericranial tenderness and oral function in patients with common migraine, muscle contraction headache and ‘combination headache’ , 1982, Pain.

[11]  P D Drummond,et al.  A Quantitative Assessment of Photophobia in Migraine and Tension Headache , 1986, Headache.

[12]  J. Olesen,et al.  Pericranial Tenderness in Tension Headache: A Blind, Controlled Study , 1985, Cephalalgia : an international journal of headache.

[13]  Hay Km.  Pain thresholds in migraine. , 1979 .

[14]  H. Pikoff.  Is the Muscular Model of Headache Still Viable? A Review of Conflicting Data , 1984, Headache.

[15]  L. Augustinsson,et al.  Muscle Tenderness in Tension Headache Treated with Acupuncture or Physiotherapy , 1990, Cephalalgia : an international journal of headache.

[16]  F. Sicuteri,et al.  Unmasking Latent Dysnociception in Healthy Subjects , 1987, Headache.

[17]  J. Olesen,et al.  Prevalence and Significance of Muscle Tenderness During Common Migraine Attacks , 1981, Headache.

[18]  Gary S. Lawrence,et al.  Significance of EMG Surface Electrode Placement Models and Headache Findings , 1988, Headache.

[19]  M. Yunus,et al.  Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. , 1981, Seminars in arthritis and rheumatism.

[20]  Thomas L. Sikora,et al.  The Effect of Postural Variation on the Electromyographic Evaluation of Tension Headache and Nonheadache Control Participants , 1986, Headache.

[21]  K. Hay.  Pain thresholds in migraine. , 1979, The Practitioner.

[22]  O. Rascol,et al.  Flunarizine versus Pizotifen: A Double‐Blind Study in the Prophylaxis of Migraine , 1986, Headache.

[23]  Ulf Lindblom,et al.  Pressure-pain threshold in human temporal region. Evaluation of a new pressure algometer , 1986, Pain.

[24]  R. Packard.  What Does the Headache Patient Want? , 1979, Headache.

[25]  John Cp Henderson,et al.  Myofascial Pain and Dysfunction: The Trigger Point Manual , 1984 .