概述

紧张性头痛通常是一种发生在头部的弥漫性、轻度至中度的疼痛,通常被描述为感觉有条带子紧束头部。紧张性头痛(紧张型头痛)是最常见的头痛类型,但发病原因尚不清楚。

存在治疗紧张性头痛的方法。通常情况下,控制紧张性头痛是指在养成健康习惯、寻找有效的非药物治疗和适当使用药物之间取得平衡。

症状

紧张性头痛的体征和症状包括:

  • 头部钝性疼痛
  • 前额、两侧和后枕部绷紧感或压迫感
  • 头皮、颈部和肩部肌肉压痛

紧张性头痛可以分为两大类,分别是发作性紧张性头痛和慢性紧张性头痛。

发作性紧张性头痛

发作性紧张性头痛可能持续 30 分钟至 1 周。频繁的发作性紧张性头痛是指每个月发作时间少于 15 天且至少持续 3 个月。频繁的发作性紧张性头痛可能变成慢性紧张性头痛。

慢性紧张性头痛

这一类型的紧张性头痛可以持续数小时,并且可能具有连续性。如果头痛每个月发作 15 天或以上且至少持续 3 个月,则被认为是慢性紧张性头痛。

紧张性头痛与偏头痛

紧张性头痛与偏头痛很难区分。而且,如果您是频繁的发作性紧张性头痛,您可能同时伴有偏头痛。

和某些类型的偏头痛不同,紧张性头痛通常不会引起视力障碍、恶心或呕吐。身体活动通常会加重偏头痛,但不会加重紧张性头痛。紧张性头痛可能出现畏光或畏声,但这些都不是常见症状。

何时就诊

与医生约诊

如果紧张性头痛已扰乱您的生活,或者您需要每周服用 2 次以上的药物来缓解头痛,则您需要去看医生。

即使您有头痛史,但只要发作方式出现变化,或者您突然感觉头痛有所不同,也应该去看医生。极少情况下,头痛可能是某一种严重疾病的征兆,例如脑肿瘤或脆弱的血管破裂(动脉瘤)。

何时寻求紧急救治

如果您出现以下体征或症状,请寻求急救护理:

  • 突发的剧烈头痛
  • 头痛伴随发热、落枕、精神错乱、癫痫发作、复视、虚弱、麻木感或言语困难
  • 头部受伤后头痛,尤其是头痛加剧时

Episodic tension-type headaches

Episodic tension-type headaches can last from 30 minutes to a week. Frequent episodic tension-type headaches occur less than 15 days a month for at least three months. Frequent episodic tension-type headaches may become chronic.

Chronic tension-type headaches

This type of tension-type headache lasts hours and may be continuous. If your headaches occur 15 or more days a month for at least three months, they're considered chronic.

Tension-type headaches versus migraines

Tension-type headaches can be difficult to distinguish from migraines. Plus, if you have frequent episodic tension-type headaches, you can also have migraines.

Unlike some forms of migraine, tension-type headaches usually aren't associated with visual disturbances, nausea or vomiting. Although physical activity typically aggravates migraine pain, it doesn't make tension-type headache pain worse. An increased sensitivity to either light or sound can occur with a tension-type headache, but this symptom isn't common.

When to see a doctor

Make an appointment with your doctor

If tension-type headaches disrupt your life or you need to take medication for your headaches more than twice a week, see your doctor.

Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different. Occasionally, headaches may indicate a serious medical condition, such as a brain tumor or rupture of a weakened blood vessel (aneurysm).

When to seek emergency help

If you have any of these signs or symptoms, seek emergency care:

  • Abrupt, severe headache
  • Headache with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties
  • Headache after a head injury, especially if the headache gets worse

病因

紧张性头痛的原因不详。过去,专家认为紧张性头痛和面部、颈部和头皮的肌肉收缩有关,可能由于情绪高涨、紧张或压力导致。但研究表明,原因不在于肌肉收缩。

最常见的理论认为,患有紧张性头痛的人对疼痛更加敏感。越来越严重的肌肉压痛是紧张性头痛的常见症状,可能是因痛觉系统敏感所致。

诱因

压力是紧张性头痛最常见的诱因。

Triggers

Stress is the most commonly reported trigger for tension-type headaches.

并发症

由于紧张性头痛非常普遍,因此它们对工作效率和整体生活质量的影响相当大,尤其是慢性紧张性头痛。经常性疼痛可能会使您无法参加活动。您可能需要停止工作待在家里,或者如果您去上班,则会损害您的工作能力。

预防

除了经常锻炼外,生物反馈训练和放松疗法等技术有助于减轻压力。

  • 生物反馈训练。这项技术指导您控制某些有助于减轻疼痛的身体反应。生物反馈治疗时,会将设备连到您身上,监测身体机能(例如肌张力、心率和血压),并提供反馈。随后,您将学习如何降低肌肉的绷紧度并减慢自己的心率和呼吸。
  • 认知行为疗法。这种类型的谈话治疗可能会帮助您学习如何管理压力,以及如何降低头痛的频率和严重程度。
  • 其他放松方法。任何有助于放松的方法,包括深呼吸、瑜伽、冥想和渐进式肌肉放松,都可能有助于缓解头痛。您可以在课堂上或家里通过书籍或磁带学习放松方法。

在减轻紧张性头痛方面,药物联合压力管理技巧可能比单独治疗更有效。

此外,健康的生活方式可能有助于预防头痛:

  • 睡眠充足,但不要睡太多。
  • 不要抽烟。
  • 经常运动。
  • 规律进食,均衡饮食。
  • 多喝水。
  • 限制酒精、咖啡因和糖的摄入量。

July 03, 2022
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