What is the pathophysiology of tension headaches?

Updated: Nov 21, 2017
  • Author: Michelle Blanda, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

While both muscular and psychogenic factors are believed to be associated with tension-type headache, most are felt to be multifactorial. A study by Kiran et al indicated that patients with chronic tension headaches for longer then 5 years tended to have lower cortisol levels. [2] This was postulated to be due to hippocampus atrophy resulting from chronic stress, a cause of chronic tension headaches. More recently it is believed that there is increased myofascial pain sensitivity caused by central factors such as sensitizatation of neurons in the supraspinal region as well as second order neurons in the spinal dorsal horn/trigeminal nucleus. [3] Another mechanism of pain is decreased antinociception or inability of the body to stop painful stimuli to the supraspinal structures. [4]


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