What is the current thinking regarding Chronic Tension Type Headache?

@rx35285
When was the last you had a MRI of your head and cervical spine? I had daily headaches for years that were tied to my cervical spinal cord/nerve root compression. I had ACDF surgery on c5-c6 and my many symptoms, including headaches, reduced significantly.

Do you have any other symptoms beyond headaches? Do you take any other medications or supplement? Do you have any sensitivity to certain foods or triggers that you know about?

Hi, I’m new here 👋

I was diagnosed around 4 years ago with cluster type tension headaches but have had nothing ever since!
But for the last 2 months I’ve had 2 weeks of headaches each month😢

Currently on my 9th day of headaches.

My health anxiety is so bad from them I feel like somethings wrong, I’m being told “it’s just a headache” “take some tablets” (tablets aren’t cutting it)

Just want some clarity if anyone has the same symptoms I’m due a doctors appointment tomorrow but my anxiety and panic is at a high tonight so could use some support.

-tight feeling around forehead and sides of head
-dull shooting pains in both sides of temples at different times (usually lasting nothing more than 5-6 seconds)
-dull shooting pains through face into jaw
-dull shooting pains at the bottom of my skull/neck
-pains in and around ear
-sore patch of scalp skin

Does anyone suffer with any of these symptoms with tension headaches?

Hi @blonde96 - glad you are here, and welcome to Mayo Clinic Connect. I wanted to let you know I moved your post here so you could connect with others talking about tension headache:

- What is the current thinking regarding Chronic Tension Type Headache? https://connect.mayoclinic.org/discussion/what-is-the-current-thinking-regarding-chronic-tension-type-headache/

Hoping here you can connect with @dlydailyhope @rx35285 and others who have backgrounds related to tension headache and can perhaps relate to anxiety.

How have you been feeling physically and emotionally the last couple hours this evening?

@blonde96 have you seen a neurologist? I have migraines and your symptoms sound familiar. With having headaches for 14 out of 30 days a month, you fit the criteria for migraines. When mine started I too was told they were caused by stress and “tension”. It wasn’t until I had a minor car accident and the headaches went from very frequent, to constant that I sought out a neurologist. Testing revealed that they were migraines, which the neurologist felt I had been dealing with since age 12 - from my medical history. The car accident had caused cervical dystonia - nerve damage in neck muscles, causing constant muscle spasms in my neck and upper back which compressed nerve bundles coming from the base of the skull. The symptoms are very similar to tension headaches caused by anxiety. If you haven’t seen a neurologist, I would recommend that you do. The headaches can be stopped by the use of Botox injections in the affected areas involved. I’ll be praying for you, as I know what you are going through. Botox has literally given me my life back - just need to get the injections every three months to control the headaches.

Thank you for the detailed information. I have seen three neurologists. My next check up is in April. Your discussion of Botox in the affected areas was most interesting. How were the muscle spasms identified and, then traced/connected to cervical dystonia? I injured some nerves, indicated by dropped shoulder, decades ago, long before the headaches began. This was caused by carrying a heavy shoulder bag (laptop). The orthopedist told me the dropped shoulder symptom may never go away but it did. I wonder if the nerve damage is latent.

Thank you again for paying forward your experience. I hope it helps others if not me.

@mbixler my daughter has cranial cervical instability and your description here is spot on. Hers was exacerbated by having the connective tissue disorder, Ehler Danlos.

I'd like to recommend getting MLS laser therapy on the back of your neck. It will tighten the ligaments in your neck and for mild - moderate cases can heal the instability. It has been a miracle for my daughter. Look for MLS cold laser therapy, also called class 4 (or higher) laser therapy, found with chiropractors or regenerative medicine centers. Costs about $50-70 per treatment, done twice a WK. Many people healed. Within 6-10 treatments.

@mensch00 Thanks for the info, but my issue is cervical dystonia - which is both a soft tissue and neurological disorder, and causes severe muscle spasms in the neck and upper back. The spasms clamp down on the bundles of nerves that go from the spine to the brain - through a notch in the skull called the occipital outlet. As long as the spasms continue the headaches do too. Botox stops those muscles from spasming for a three month period, with amazing relief. Because I also have an unstable spine caused by a serious rear end car accident, my neurologist is reluctant to play around with different therapies. I appreciate your advice though.

@mbixler -I have a question for you regarding Botox Injections. I am told I have a
rare kind of headache....Hypnic Headache...it only comes at night when you're sleeping.
Usually about 2 hours into REM sleep.

I had been taking Fiorcet for it but have built up an immunity to it... My Neurologist then suggested Botox injections...I have already had three rounds of Botox but not quite having
the results I want.
1. How long have you been doing the Botox shots?
2. How long before it came effective?
3. I tend to get headaches for about a week after the shots...have you experienced
the same???
4. My head pains are now changing....not waking me up but changing the time to mornings?????
My doctor is baffled and now suggesting daily meds along with giving myself a shot of other
meds. I am not interested in pursuing this routine and just started to try therapeutic massages.
I also have another problem but have found a pretty decent solution. I have trigeminal
nerve pain caused by a dentist...I found out thru Mayo Clinic about a non-invasive nerve
pain treatment that is also painless...called Scrambler Technique. it has been pretty effective and wished it worked on my headpains.

Thank you in advance for any info on your Boxtox treatments. Regards...

@duchess926 Hi, I have been getting Botox for over 25 years now. Was treated with numerous other medications, with little to no relief and many nasty side effects. My 4th neurologist finally made the correct diagnosis and treatment. I got immediate relief after my 1st round of Botox, with no side effects to speak of - other than mild headaches for the first week or so. I had deep tissue massage three times per week for over a year - neck to mid-back, and had some relief that would last 36 to 48 hours, but then migraines would come thundering back. It sounds like our diagnosis is rather different. I hope they figure out what treatment will help you. Will be praying for you.

@mbixler
WOW!!! Botox for 25 years!! Amazing...glad to read it's been so helpful for you.

I just started getting massages and hoping that it helps....all my Neurologist wants
to do is keep on suggesting medications and injections with either Aimovig, Emgality or Ajovy...
I'm not interested in any of that and will stick to the Botox, massages and trying to get back to
working out...appreciate your input!!!