Tension-type headache

Tension-type headache (TTH) can occur in short episodes of varying duration (episodic form) or continuously (chronic form). Infrequent episodic TTH (< 1 day of pain per month) usually requires no medical treatment beyond simple analgesics. In contrast, patients with frequent episodic tension-type headache (ETTH; between 12 and 180 days of headache per year) and chronic TTH (CTTH; at least 180 days of headache per year) can face considerable disability and require specific intervention.

The lifetime prevalence of tension-type headache is approximately 78%. Between 24% and 37% of patients suffer from tension-type headache several times a month, 10% weekly, and between 2% and 3% suffer from CTTH, which often lasts for most of their lives.

Since many secondary headaches can mimic tension-type headache, the diagnosis of TTH requires the exclusion of other organic diseases. In most patients, TTH evolves from the episodic to the chronic form, and peripheral nociceptive stimuli from pericranial myofascial tissues appear to be responsible for the conversion of ETTH to CTTH.

TTH is considered the prototype of headaches in which myofascial pain plays a significant role. Numerous reports have indicated an increase in the number of active and latent myofascial trigger points in the pericranial muscles of patients with ETTH and CTTH. These active and latent myofascial trigger points can be found in the suboccipital, splenius capitis, splenius cervicis, semispinalis capitis, semispinalis cervicis, levator scapulae, and upper trapezius muscles. Short-term headache relief through myofascial trigger point release has proven successful with CTTH.

ETTH and CTTH can be treated with RSWT using the Swiss DolorClast© to focus on the treatment of active and latent myofascial trigger points in the muscles of the suboccipital area, splenius capitis, splenius cervicis, semispinalis capitis, semispinalis cervicis, levator scapulae, and upper trapezius.