Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0234233 (Tenderness)
 375 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty patients with tension headache and 40 healthy comparable control persons were palpated by the same "blinded" observer. Tenderness in 10 pericranial muscles on each side was rated on a four-point scale. A Total Tenderness Score was calculated for each individual by adding the scores from all palpated areas. Headache patients had significantly higher scores than controls and also significantly higher tenderness in each point separately. Median normal values and confidence limits for tenderness are given. Among 23 patients with daily headache a correlation was found between headache intensity and Total Tenderness Score. It is likely that the pathologic tenderness in patients with tension headache is the source of nociception, but pain mechanisms are more complex, as evidenced by discrepancy between tenderness and pain in some patients. Pathologic tenderness should be a contributing criterion to the diagnosis of tension headache (muscle contraction headache).
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PMID:Pericranial tenderness in tension headache. A blind, controlled study. 342 25

Skin roll tests were performed on 15 patients with cervicogenic headache, 15 with tension headache ("tension-type headache"; 6 with the acute ("episodic") and 9 with the chronic form), and 43 migraine without aura patients (15 without and 28 with sideshift). Three positions (trapezius, mandibular, supraorbital) were used. The results were compared with those obtained in a control series (no. = 95). Fourteen cervicogenic (93.3%), 8 tension headache (53.3%), and 8 migraine (18.6%) patients reported tenderness in the trapezius position during the procedure. Tenderness asymmetry of > or = 10 mm on the visual analogue scale (with the highest value on the symptomatic side; trapezius position) was found in 10 (67%) cervicogenic headache patients, vs 3 (20%) tension headache patients and no migraine patients. A clear tenderness asymmetry in this area may suggest a cervicogenic headache rather than a migraine without aura diagnosis. Thickness values were less helpful in distinguishing cervicogenic headache from other headaches. In the cervicogenic headache group, both tenderness and skinfold thickness showed significantly higher values on the symptomatic than on the non symptomatic side in the trapezius position, but not in the other positions. The differences between cervicogenic headache on the one hand and tension headache/migraine on the other were generally rather small, indeed, there was a considerable overlap between the groups. In single cases, therefore, the skin roll test will contribute little to the differential diagnosis of cervicogenic headache.
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PMID:The "skin roll" test: a diagnostic test for cervicogenic headache? 962 97

In this present thesis I have discussed the epidemiology and possible pathophysiological mechanisms of tension-type headache. A population-based study of 1000 subjects randomly selected from a general population, two clinical studies, and a method study of EMG recordings, were conducted. Tension-type headache was the most prevalent form of headache, with a life-time prevalence of 78% in a general adult population. Thirty percent were affected more than 14 days per year and 3% were chronically affected, i.e. had headache at least every other day. Females were more frequently affected than males, and young subjects more frequently affected than older subjects. Females were more sensitive to mechanical pressure pain and revealed more tenderness from pericranial muscles and tendon insertions than males, and young subjects were more pain-sensitive than older subjects. Significantly higher tenderness in pericranial muscles was found in subjects with tension-type headache compared to migraineurs and to subjects without any experience of headache. Tenderness increased significantly with increasing frequency of tension-type headache in both males and females, whereas no such relation was found for mechanical pain thresholds. The applied EMG methodology was fairly reliable and nonpainful, but due to intersubject variability paired studies should be preferred. Subjects with chronic tension-type headache had slightly increased EMG levels during resting conditions and decreased levels during maximal voluntary contraction compared with headache-free subjects, indicating insufficient relaxation at rest and impaired recruitment at maximal activity. In a subsequent clinical, controlled study, the effect of 30 min of sustained tooth clenching was studied. Within 24 h, 69% of patients and 17% of controls developed a tension-type headache. Shortly after clenching, tenderness was increased in the group who subsequently developed headache, whereas tenderness was stable in the group of patients who remained headache-free, indicating that tenderness might be a causative factor of the headache. Likewise, psychophysical and EMG parameters were studied in 28 patients with tension-type headache, both during and outside of a spontaneous episode of tension-type headache. It was concluded that a peripheral mechanism of tension-type headache is most likely in the episodic subform, whereas a secondary, segmental central sensitization and/or an impaired supraspinal modulation of incoming stimuli seems to be involved in subjects with chronic tension-type headache. Prolonged nociceptive stimuli from myofascial tissue may be of importance for the conversion of episodic into chronic tension-type headache. The author emphasizes that tension-type headache is a multifactorial disorder with several concurrent pathophysiological mechanisms, and that extracranial myofascial nociception may constitute only one of them. The present thesis supplements the understanding of the balance between peripheral and central components in tension-type headache, and thereby, hopefully, leads us to a better prevention and treatment of the most prevalent type of headache.
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PMID:Pathophysiological mechanisms of tension-type headache: a review of epidemiological and experimental studies. 1044 49

To assess in patients with migraine and tension type headache, both episodic and chronic, the extent to which muscle tenderness may relate to anxiety and depression, 459 patients with Episodic Migraine (EM, 125), Chronic Migraine (CM, 97), Episodic Tension Type Headache (ETTH, 82), Chronic Tension Type Headache (CTTH, 83), and EM+ETTH (72) were enrolled. For each patient, a psychological assessment on the Axis 1 of the DSM-IV and muscle palpation of pericranial and cervical muscles were carried out. A Pericranial Muscle Tenderness Score (PTS) and a Cervical Muscle Tenderness Score (CTS) were calculated (range 0-3). Logistic and linear regression analyses were employed to assess relations between muscle tenderness, the demographic variables and psychiatric disorders in the different patient groups. Odds ratio for 'male gender' was higher in groups with tension type headache. Only EM patients showed a positive association with increasing age. Anxiety and depression were significantly associated to CM. A significant negative correlation of PTS and CTS was observed in EM patients. In relation to male gender, the PTS was significantly lower in EM, ETTH and CTTH; CTS was significantly lower in EM, CM, and CTTH. Anxiety and, even more, anxiety and depression combined were positively associated to higher PTS and CTS in EM patients. Anxiety and depression were also positively associated to higher CTS in patients with EM+ETTH. In CTTH patients, PTS only was positively associated to anxiety and depression. We conclude that in patients with EM, the presence of anxiety or anxiety and depression combined considerably increases the level of muscle tenderness in the head and, even more, in the neck, and might facilitate the evolution into CM.
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PMID:Muscle tenderness in different headache types and its relation to anxiety and depression. 1549 85