N95 Tension headache (ICD-10:G44.2)

Introduction

Tension headaches are a common type of headache characterized by a dull, aching pain and a sensation of tightness or pressure around the head. They can be caused by various factors, including stress, muscle tension, and poor posture^[1]. The aim of this guide is to provide healthcare professionals with a comprehensive overview of the diagnostic steps and possible interventions for tension headaches.

Codes

• ICPC-2 Code: N95 Tension headache
• ICD-10 Code: G44.2 Tension-type headache

Symptoms

• Dull, aching pain in the head
• Sensation of tightness or pressure around the head
• Tenderness in the scalp, neck, or shoulder muscles
• Mild to moderate pain intensity
• Pain that is not worsened by physical activity^[2]

Causes

• Muscle tension in the head, neck, and shoulder muscles
• Emotional stress or anxiety
• Poor posture
• Eye strain
• Fatigue
• Caffeine withdrawal
• Jaw clenching or teeth grinding^[3]

Diagnostic Steps

Medical History

• Obtain a detailed medical history, including information about the patient’s symptoms, their duration and frequency, and any triggers or alleviating factors.
• Ask about the patient’s lifestyle, including their stress levels, sleep patterns, and use of medications or recreational drugs.
• Inquire about any previous history of headaches or other medical conditions that may contribute to the development of tension headaches^[4].

Physical Examination

• Perform a thorough physical examination, focusing on the head, neck, and shoulder muscles.
• Palpate the scalp, neck, and shoulder muscles for tenderness or trigger points.
• Assess the patient’s posture and range of motion in the neck and shoulders.
• Check for any signs of temporomandibular joint dysfunction, such as jaw clicking or limited jaw movement^[5].

Laboratory Tests

• Laboratory tests are generally not necessary for the diagnosis of tension headaches.
• However, if there are concerns about an underlying medical condition, such as an infection or inflammation, blood tests may be ordered to rule out other causes of the headache ^[6].

Diagnostic Imaging

• Diagnostic imaging is not typically required for the diagnosis of tension headaches.
• However, if there are atypical features or red flags suggesting a more serious underlying cause, such as a brain tumor or aneurysm, imaging modalities such as CT scans or MRIs may be considered^[7].

Other Tests

• Other diagnostic tests, such as electromyography (EMG) or nerve conduction studies, may be ordered if there is suspicion of muscle tension or nerve involvement in the headache^[8].

Follow-up and Patient Education

• Schedule a follow-up appointment to assess the patient’s response to treatment and adjust the management plan if necessary.
• Provide patient education on stress management techniques, relaxation exercises, and lifestyle modifications that may help prevent or alleviate tension headaches.^[9][10]

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for tension headaches:

1. Acetaminophen (e.g., Tylenol):
   • Cost: $5-$15 for a bottle of 100 tablets.
   • Contraindications: Allergy to acetaminophen, severe liver disease.
   • Side effects: Rare at therapeutic doses.
   • Severe side effects: Liver damage (with excessive use).
   • Drug interactions: None significant.
   • Warning: Do not exceed the recommended dosage.
2. Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., Ibuprofen, Naproxen):
   • Cost: $5-$20 for a bottle of 100 tablets.
   • Contraindications: Allergy to NSAIDs, history of gastrointestinal bleeding or ulcers.
   • Side effects: Upset stomach, heartburn.
   • Severe side effects: Gastrointestinal bleeding, kidney problems.
   • Drug interactions: Anticoagulants, other NSAIDs.
   • Warning: Take with food to reduce the risk of stomach upset.
3. Triptans (e.g., Sumatriptan, Rizatriptan):
   • Cost: $15-$50 for a pack of 9 tablets.
   • Contraindications: History of heart disease, uncontrolled high blood pressure.
   • Side effects: Tingling or warmth sensation, dizziness.
   • Severe side effects: Chest pain, shortness of breath.
   • Drug interactions: SSRIs, MAO inhibitors.
   • Warning: Do not use more than 2 doses in 24 hours.
4. Muscle relaxants (e.g., Cyclobenzaprine, Methocarbamol):
   • Cost: $10-$30 for a bottle of 100 tablets.
   • Contraindications: Glaucoma, urinary retention.
   • Side effects: Drowsiness, dry mouth.
   • Severe side effects: Severe allergic reactions, irregular heartbeat.
   • Drug interactions: Sedatives, alcohol.
   • Warning: Avoid driving or operating machinery while taking muscle relaxants.
5. Antidepressants (e.g., Amitriptyline, Venlafaxine):
   • Cost: $10-$50 for a bottle of 100 tablets.
   • Contraindications: Recent heart attack, narrow-angle glaucoma.
   • Side effects: Dry mouth, drowsiness.
   • Severe side effects: Suicidal thoughts, serotonin syndrome.
   • Drug interactions: MAO inhibitors, other antidepressants.
   • Warning: May take several weeks to achieve full effect.

Alternative Drugs:

• Botulinum toxin injections: Can be considered for patients with chronic tension headaches who do not respond to traditional interventions. Cost: $500-$1500 per treatment session.
• Anticonvulsants (e.g., Topiramate, Valproate): May be used for patients with frequent or refractory tension headaches. Cost: $10-$50 for a bottle of 100 tablets.
• Benzodiazepines (e.g., Diazepam, Lorazepam): Can be used for short-term relief of tension headaches associated with anxiety or muscle tension. Cost: $5-$20 for a bottle of 100 tablets.
• Beta-blockers (e.g., Propranolol, Metoprolol): May be effective in reducing the frequency and severity of tension headaches. Cost: $10-$30 for a bottle of 100 tablets.
• Calcium channel blockers (e.g., Verapamil, Diltiazem): Can be considered for patients with tension headaches associated with vascular changes. Cost: $10-$30 for a bottle of 100 tablets.

Surgical Procedures:

• Surgical procedures are not typically indicated for the treatment of tension headaches.

Alternative Interventions

• Acupuncture: May help reduce the frequency and intensity of tension headaches. Cost: $60-$120 per session.
• Chiropractic manipulation: Can provide relief for tension headaches caused by musculoskeletal imbalances. Cost: $50-$100 per session.
• Massage therapy: May help relax tense muscles and alleviate tension headaches. Cost: $60-$100 per session.
• Yoga and meditation: Can help reduce stress and promote relaxation, potentially reducing the frequency of tension headaches. Cost: Varies depending on the location and instructor.
• Herbal supplements: Some herbs, such as feverfew and butterbur, have been used for the prevention of tension headaches. Cost: Varies depending on the specific supplement.

Lifestyle Interventions

• Stress management: Encourage patients to identify and manage sources of stress in their lives through techniques such as deep breathing, meditation, or counseling. Cost: Varies depending on the specific stress management technique.
• Regular exercise: Engaging in regular physical activity can help reduce muscle tension and promote overall well-being. Cost: Varies depending on the type of exercise (e.g., gym membership, fitness classes).
• Improving posture: Educate patients on proper posture and ergonomics to reduce strain on the neck and shoulder muscles. Cost: None or minimal cost.
• Relaxation techniques: Teach patients relaxation exercises, such as progressive muscle relaxation or guided imagery, to help alleviate tension headaches. Cost: None or minimal cost.
• Sleep hygiene: Advise patients to establish a regular sleep schedule and create a sleep-friendly environment to promote restful sleep. Cost: None or minimal cost.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – N95 Tension headache (ICD-10:G44.2)

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Use the Mirari Cold Plasma device to treat Tension headache effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Tension headache. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. WebMD. Tension Headache: Symptoms, Causes, Treatment, and Prevention. https://www.webmd.com/migraines-headaches/tension-headaches
2. Healthline. Tension Headaches: Causes, Symptoms, and Treatments. https://www.healthline.com/health/tension-headache
3. Johns Hopkins Medicine. Tension Headaches. https://www.hopkinsmedicine.org/health/conditions-and-diseases/headache/tension-headaches
4. Cleveland Clinic. Tension Headache: What It Is, Causes, Symptoms & Treatment. https://my.clevelandclinic.org/health/diseases/8257-tension-headaches
5. Verywell Mind. Tension Headache: Symptoms, Causes, Diagnosis, Treatment, Coping. https://www.verywellmind.com/what-is-a-tension-headache-5224450
6. American Migraine Foundation. Tension-Type Headache. https://americanmigrainefoundation.org/resource-library/tension-type-headache/
7. Mayo Clinic. Tension headache. https://www.mayoclinic.org/diseases-conditions/tension-headache/symptoms-causes/syc-20353977
8. National Headache Foundation. Tension-Type Headache. https://headaches.org/2007/10/25/tension-type-headache/
9. American Academy of Family Physicians. Tension-Type Headaches. https://familydoctor.org/condition/tension-type-headaches/
10. Medscape. Tension Headache. https://emedicine.medscape.com/article/792384-overview