Talk:Tension headache

Causes
"Although muscle tension may be involved, many researchers now question this idea, and recent research has shown that tension headache patients do not have increased muscle tension.[4]"

Although, I dont especially doubt the statement, the reference (http://www.mayoclinic.com/health/tension-headache/DS00304) does not back up the statement. I'll not take this out of the article myself, I advise whoever put it there (or anyone else with the time), looks for references to back up the statement or takes the statement out.

BlackDice572 17th sept 09

In
In the book It's Not A Tumor, Wiedemeyer says that muscle tension is the cause of 80% of all headaches (migranes 15%). He says these muscle "contraction" headaches are mostly caused by stress, which creates increased extraneous electrical activity in the brain which creeps down the spinal cord to nerves that control muscles in the head and neck causing them to contract which compresses the pain-carrying nerves there, producing the headache. Is this a real explanation or what people call "quackery"? A pointed explanation in layman's terms is very appropriate, and in the spirit of wikipedia, I think. He also has a neat explanation for migraines or "vascular" headaches- instead of muscle contractions squeezing the nerves inside the muscles, it's artery dilation stretching those nerves encircling the arteries. Causes of dilation include spasms of artery muscle, and less often, inflammation. Not much explanaiton on what causes the spasms but they often first invlve contraction, affecting vision, then dilation stretching the nerve, causing the headache.

Renaming
Does the International Headache Society have enough traction to get a substantial portion of the medical community calling these 'tension-type' headaches? If not, they probably don't deserve mention in the first sentence of the article. -Toptomcat 22:17, 8 October 2006 (UTC)

Depends on what you mean by traction. They're the largest professional association devoted to the study and treatment of headache disorders. Their International Headache Society's International Classification of Headache Disorders, 2nd Edition, is pretty universally accepted as the "gold standard" for classification and diagnosis. It's through their work and this document that what used to be "classic migraine" is now known as migraine with aura and "common migraine" is now known as migraine without aura. I'm not really sure what you meant, but does this answer the question?

--TeriRobert 08:04, 27 November 2006 (UTC)

Having Headaches
Everyone will have at least one tension headache in their lifetime. — This statement isn't necessarily true Carnivorous caveman 04:54, 26 November 2006 (UTC)

Pain and Possible Symptoms
I removed the following from the Pain and Possible Symptoms section:

Pain arising from tension in the neck can often be identified by comparing any pain caused by coughing or sneezing normally with that which arises while pressing with one's hand against the forehead (which reduces the tension placed on the muscles at the back of the neck). If the pain is less it suggests that muscular tension in the neck is the cause of the headache.

Reasons:
 * The statement of the test interpretation is completely ambiguous. "If the pain is less" could be interpreted either that the first pain is less than the second pain or vice versa.
 * No citation was given showing where this test came from or showing it to be accurate or meaningful.
 * I researched trying to find a clearer statement of this test and its interpretation (my first preference being to merely clarify the statement) and could find no reliable source to suggest this test be performed for any reason. Several reliable medical articles on diagnosing headaches and differentiating one type of headache from another contained no such test or suggestion of this type of test, while the only references I could find to this test have the exact same wording and ambiguity, leading me to believe that they took it from this article or supplied the initial entry based on original research.

If someone can clarify the test interpretation and provide a citation, I would be happy to see that put in the article.

Jgro 15:10, 31 July 2007 (UTC)

Acupuncture
Is the comment on acupuncture really necessary? Usually something not working is not relevant unless there is widespread belief that it does work. --Banyan (talk) 01:02, 14 August 2008 (UTC)
 * Right now there is a nice Cochrane review which describes the effectiveness of this treatment.  Blue Rasberry   (talk)  19:40, 25 May 2016 (UTC)

Health information from a consumer source
I just added information in the treatment and prevention sections of this article from this source. This is a source at the edge of WP:MEDRS. What I added is a consumer perspective of what happens during treatment, starting with basics (stress relief and drinking water) to over the counter treatments on to visits to the doctor. What I added ends around the point when a health care provider begins to be involved, and where more academic MEDRS sources would begin.  Blue Rasberry  (talk)  20:43, 25 May 2016 (UTC)

Image removal?
BRD time. I removed the image because I feel it is distracting and poor. I don't think we need an image to illustrate the concept of a headache. And I sort of commiserated with some other editors who didn't tell me no. Would you rather I filed an RfC to gain consensus? Thanks, L3X1 (distænt write)  18:24, 20 September 2017 (UTC)
 * Sure. I am not seeing what is wrong with showing someone with the typically headache response.
 * The image rapidly orients people to what the article is about and thus serves its purpose. Doc James  (talk · contribs · email) 18:32, 20 September 2017 (UTC)
 * Sorry, I hit the wrong button! Will file soon. L3X1 (distænt write)  18:58, 20 September 2017 (UTC)

RfC for infobox image

 * The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.


 * Keep Clear consensus for keeping the image, which ahs now been shrunk a bit in size. I suppose if anyone wants a selfie in Wikipedia, now is the time to add it :) Thanks all for participation. L3X1 (distænt write)  03:33, 5 October 2017 (UTC)


 * Should the Infobox image of a woman holding her head be removed?

I believe so because:
 * it is distracting: Image is very large, and takes your attention from the matter at hand.
 * it is a poor image: poorly lit, poorly composed, background is overexposed, everything beneath her wrists can be cropped.
 * it doesn't illustrate properly: Our article on GSW doesn't show a shot man writhing on the ground. Our article on Heart attacks doesn't show a senior clutching his chest. Torsioned ovary doesn't show a woman bring loaded into an ambulance on her way to ER.

I disagree with User:Doc James on his points for the above reasons. I feel the image rapidly distracts from the topic at hand and fails to illustrate any difference between Tension headache and any other Headache. And I don't approve of that image either, though it is better composed. I am aware that articles like depression and ADHD have images along the same lines. But Erectile dysfunction doesn't! If a picture is going to be included for this article, can a better one be submitted? Thanks, L3X1 (distænt write)  02:02, 21 September 2017 (UTC)


 * Keep image Gives a rapid orientation to the topic in question. Happy to use a better one if you have one. Doc James  (talk · contribs · email) 02:14, 21 September 2017 (UTC)
 * Remove image it is too large and poor quality. Absolutelypuremilk (talk) 14:52, 21 September 2017 (UTC)
 * Keep image. The quality image represents the topic. It can be replaced if a better image is available in the future. If an image is too large or to small it can usually be adjusted. Other similar articles have an image in the infobox. QuackGuru  ( talk ) 12:42, 22 September 2017 (UTC)
 * In case editors want to adjust the size they can. QuackGuru  ( talk ) 16:34, 22 September 2017 (UTC)
 * Keep image It is a bit grainy, and a wee bit too big. Bottom third could be removed. It could be sent to photo lab to be processed. I think it has a low dpi count. Resize it. scope_creep (talk) 15:14, 24 September 2017 (UTC)
 * Keep image, however it is hard to know what the woman is going through. A migraine? A cluster headache? Some of pathological headache that would indicate a stroke, hydrocephalus, or a tumor? Sensory overload or sound sensitivity, even? I see s' point. Maybe the current image would be more suited for the article alongside another image that somehow indicates the muscles involved in tension headaches. I was recruited by the feedback request service. I dream of horses If you reply here, please ping me by adding to your message (talk to me) (My edits) @  04:34, 25 September 2017 (UTC)
 * Keep image or similar image of better quality. Perhaps an image where the pain appears to be located occipitally. PizzaMan (♨♨) 21:50, 25 September 2017 (UTC)
 * Replace image with a higher-quality alternative. Having an image depicting the subject in general would not be distracting, but this excessively large, poor-quality one is quite so, to the point of giving me a tension headache. Kerdooskis (talk) 19:12, 28 September 2017 (UTC)
 * Happy to consider other higher quality images Doc James  (talk · contribs · email) 05:56, 29 September 2017 (UTC)
 * Keep image at the very least until more useful image/s can be found. This image is not particularly large, certainly not large enough to have any seriously distracting effect on the text layout. Though, taken in isolation, it is not clear that the subject has a headache, her attitude and appearance in context are thoroughly consistent with the Signs and symptoms section. Simple removal would not improve the article and IMO would impoverish it. It is much harder to find something better than to complain about what one has at present. As for the artistic merit, fine... Find something better and more informative first, then criticise. JonRichfield (talk) 06:58, 30 September 2017 (UTC)
 * Keep image: a little cropping/resizing/touch-up might do it good until a better one is found, but a picture would be good for the article. It also doesn't seem to be significantly distracting. Until a better one is found, let's keep this one. --Nerd1a4i (talk) 00:19, 1 October 2017 (UTC)
 * Keep image unless a better one is found. But it is too big – this could easily be corrected by editing the fifth line of the article, which says "image_size     = 250px". Maproom (talk) 07:00, 2 October 2017 (UTC)
 * Nom Com Here I shrunk the image down to 180px, which I think improves the look. Is that too small?L3X1 (distænt write)  13:38, 2 October 2017 (UTC)
 * 180px is too small. The current size is significantly smaller than the previous image size. QuackGuru  ( talk ) 16:35, 2 October 2017 (UTC)
 * Keep image - The image is good and relevant, but could be reduced in size. Cwmhiraeth (talk) 10:13, 3 October 2017 (UTC)
 * Keep image but seek replacement. I believe this RfC was opened too hastily when other measures such as 3O or just waiting for others' input would have been more appropriate. Nihlus 06:01, 4 October 2017 (UTC)


 * The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Wikiproject Medicine
Hello I am a 4th year medical student currently taking a course called Wikiproject, which was set up to allow for medical students to put efforts towards improving wikipedia pages about medical topics. This is just one course devoted to the larger goal of Wikiproject medicine. Over the next four weeks of this course I will be helping to structure and add information to this page. I am pursuing neurology as my specialty and I am very interested in headache/migraine. This article has some good information and my goal is to help add more content to this high importance topic and to improve the overall C-class rating. I hope to add/improve the following sections:

1. Add a classification section. Currently, under signs and symptoms there is sub-classification of tension headache mentioned. Moving this content and adding some more information about the subtypes to a separate classification system will hopefully improve structure and flow of the article.

2. Potentially add a brief diagnosis section including patient friendly explanation of workup/evaluation and differential diagnosis.

3. Breakdown the causation section into simpler terms for better audience understanding. The article details the believed pathophysiology, but some terms may be too scientific for the lay person to understand or just need further breakdown. I would also like to replace with more current information. Add in citations from systematic review and meta-analysis study material. 4. Add content to the treatment section. This section has a nice broad overview of available medications and does a good job covering different types of manual therapy. I would like to bolster this section by adding some more content and explanation of the available medications. I would also like to add more current information to the manual therapy section and discuss briefly information regarding other alternative modalities such as acupuncture (already mentioned) and mindfulness/stress reduction techniques.

Any suggestions are welcomed and thank you for your help! Ucfmed2019 (talk) 02:45, 9 January 2019 (UTC)

Feedback for WikiProject Edits
Amazing job organizing and updating this article! The citations are appropriately placed, and I found all of the links to be functional. I really liked how the subsections were organized with bullet points rather than long, wordy paragraphs. I think it's a lot easier to read and follow when it's concise like that.

The expansion on the classification section looks great, and I think it's definitely explained in a way that would be understandable to everyone. For the sentence defining CTTH, I would maybe add a comma after "three months" and after "one-hundred eight days or more" so that the distinction between the two criteria is clearer. Same thing with the frequent TTH definition, I would maybe reword it or add commas to make it a little bit easier to understand. Maybe the first part can read "[...]ten or more episodes of headache over the course of fourteen days per month for more than three months, or at least twelve days per year. However, it must be less than one-hundred eight days per year." or something.

In the "Overview of Pathophysiology of ETTH and CTTH" section under "Mechanism", there is a typo in the sentence that starts with, "Peripheral pain pathways receive pain signals from [...]" where it says "like" instead of "likely". Further down in that same section, there is a typo in the sentence that starts with, "It is then these prolonged alterations in the peripheral pain pathways[...]" that should say, "that lead" instead of "lead". In that same sentence, adding a comma after "central nervous system pain pathways" would help with making seem less like a run-on.

In the "Diagnosis" section, I would add a comma after "muscles" in the first sentence to separate the 3 "or's". The differential diagnosis list is awesome! I would maybe add links to some of those differentials' Wiki pages [for the ones that have ones, like "medication overuse headache"].

I really like the treatment section; it's thorough and concise at the same time. It provides multiple approaches and just enough to explain each of them. To clarify, did all of the info in the "Treatment of CTTH" section's first paragraph come from one source? In the next paragraph that same source is then cited twice, so wasn't sure how citations were being structured here.

Overall, awesome job!!! It's extremely thorough and well organized, and it's simple to read! — Preceding unsigned comment added by Smangal06 (talk • contribs) 03:23, 30 January 2019 (UTC)