Tension Headache & TMJ

Question 1

What is the most common type of headache?

Answer 1

Tension type headache (>80%)

Question 2

What should you consider when a patient says this is the “worst headache of their life?”

Answer 2

subarachnoid hemorrhage = EMERGENCY

Question 3

What should you consider when a patient complains of new onset of focal neurological weakness?

Answer 3

Stroke = EMERGENCY

Question 4

What should you condor when at patient at the age of 50 or older complains of headaches?

Answer 4

Temporal arteritis or a potential neoplasm

Question 5

What should you consider if a patient complains of acute eye pain with a headache?

Answer 5

Acute angle glaucoma = EMERGENCY

Question 6

What should you consider if a patient has elevated blood pressure with a headache complaint?

Answer 6

Hypertensive emergency + EMERGENCY

Question 7

What is the pain pattern of tension-type headache?

Answer 7

bilateral tight/ achy pain/ band-like

Question 8

What is the typical radiation pattern of tension-type headaches?

Answer 8

occipital to cervical (from back to front)

Question 9

What are three common causes of tension-type headaches?

Answer 9

Myofascial pain referral
Cervical facet referral
Temporomandibular joint (TMJ) dysfunction

Question 10

Myofascial Pain Referral comes from what?

Answer 10

trigger points; referred muscle pain

Question 11

Description of trigger points

Answer 11

discrete, focal and hyperirritable; palpable nodule “knot” in the muscle; produces a twitch response when palpated

Question 12

a palpable “knot” in a muscle that produces a twitch response when palpated?

Answer 12

trigger point

Question 13

Differences between trigger points and tender points?

Answer 13

Trigger points - characteristic pain pattern, only located in muscle, elicits a radiating pain pattern, presents with a taut band of tissue and elicits a twitch response with palpation

Tension points - no characteristic pain pattern; located in many tissues; no radiating pain pattern; a taut band is not present and a twitch response is not produced after palpation

Question 14

What is the main conservative treatment for tension type headache due to myofascial pain referral?

Answer 14

ischemia compression AKA Soft tissue

Question 15

What is the main conservative treatment for tension type headache due to cervical facet referral?

Answer 15

manual medicine (OMM that targets articular dysfunction)

Question 16

What is the common internal cause of tension type headaches caused by TMJD

Answer 16

malocclusion and bruxism (grinding teeth)

Question 17

What is the main conservative treatment for tension type headache due toTMJD?

Answer 17

manual medicine (articular, fascial, muscles)