Received 08/12/2023
DOI: 10.35556/idr-2024-2(107)36-41
Clinical characteristics of tension headache in occlusive disorders
Didenko N.M.1, ORCID ID: 0000-0003-1440-2484; SPIN-code: 6254-5322; Author ID: 234119,
Ushakov R.V.2, ORCID ID: 0000-0003-4821-1758; SPIN-code: 3053-3900; Author ID: 701309,
Mokrenko E.V.1, ORCID ID: 0000-0002-4286-3993; SPIN-code: 7315-5961; Author ID: 387086
1Federal State Budgetary Educational Institution of Higher Education “Irkutsk State Medical University” of the Ministry of Health of the Russian Federation
664003, Russia, Irkutsk, Krasnogo Vosstaniya St., 1
2Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuing Professional Education” of the Ministry of Health of the Russian Federation, Moscow
125993, Russia, Moscow, Barrikadnaya St., 2/1, Bld.1

E-mail address: ortodont.irk@gmail.com

Summary
Relevance. Common physiological human suffering is headache. The prevalence of headache ranks third after back pain and joint pain in the structure of muscle-fascial pain syndromes. However, headaches and facial pains associated with muscle-fascial trigger points are much more common than headaches and facial pains caused by other causes. An extremely irritated area of skeletal muscle associated with an oversensitive palpable node located in a compacted bundle is the muscle–fascial trigger points. In the pathogenesis of headaches, a major role belongs to dysfunction or disease of the temporomandibular joint, age-related changes in the masticatory muscles, jaws and teeth and all elements of the TMJ occuring during a person’s life. In some cases, minor changes in the occlusion of teeth and jaws, as well as a stressful situation, lead to a painful spasm of the masticatory muscles.
Goal. To analyze the clinical characteristics of tension headache in patients with occlusive disorders (OD) and physiological occlusion (PO).
Material and methods. The study covered 210 patients with occlusion disorders and 92 patients with the signs of physiological occlusion. 141 patients from the first group and 32 patients from the second group complained of a headache. Occlusal relationships of teeth were analyzed in the position of central and dynamic occlusion. The destruction of the hard tissues of the teeth and partial adentia, as well as anomalies and deformities of the dentition were determined as the disorder of occlusion. The study of the muscles of the maxillofacial region and neck was carried out using the techniques described in the book by Travell J.G., Simons D.G. (2005). A visual-analogue pain assessment scale and a Russified McGill’s questionnaire on the nature of pain were used to identify the nature of the pain syndrome, the severity of pain. The assessment was carried out at a consultative appointment, the localization, nature, duration and intensity of pain, as well as the specificities of the pain syndrome being taken into account. When examining muscles, to quantify the data obtained the muscle syndrome index (IMS) was evaluated. The analysis of the research results was carried out using nonparametric criteria.
Results. According to the severity of the pain syndrome, the use of a visual analogue scale (VAS) of pain allowed us to divide all patients into 3 groups: with mild pain, with moderate and with severe pain. According to the international classification of headaches, episodic and chronic headaches were distinguished. In patients with OD, the headache becomes chronic more often and is felt more intense than in patients with PO. Among the patients complaining of a headache, in patients with OD the IMS is higher than the IMS of the muscles of the masticatory complex, and in patients with PO the IMS is higher than the IMS of the neck muscles.
Conclusions. Female patients with OD and PO suffer from tension headache more often than male patients. In patients with OD, musculo-fascial headaches are twice as common, have a more pronounced character and become chronic more often than in patients with PO. The severity of the IMS of the masticatory muscles in patients with OD is 2.5 times higher than in patients with PO.

Keywords: tension headache, occlusion disorders, statistical research methods.

The authors declare there is no conflict of interest.

For citation: Didenko N.M., Ushakov R.V., Mokrenko E.V. Clinical characteristics of tension headache in occlusive disorders. Stomatology for All / Int. Dental Review. 2024; no.2(107): 36-41 (in Russian). doi: 10.35556/idr-2024-2(107)36-41

References
1. Kislova E.A., Latysheva N.V., Filatova E.G. Headache diagnoses in patients with orofacial pain at a specialized pain center. Medical alphabet. 2023; no.2: 7—11 (in Russian). doi: 10.33667/2078-5631-2023-2-7-11
2. Blitsyn K., Adamidu A. Comparative analysis of the frequency of headache and pain in the lumbar region of the back in students. Mechnikov readings. 2022; Materials of the 95th All-Russian Scientific and Practical Student Conference with international participation. Saint-Peterburg. 2022; 59—60 (in Russian).
3. Stovner L.J., Hagen K., Linde M., Steiner T.J. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. Headache Pain. 2022 Apr 12; 23(1): 34 p. doi: 10.1186/s10194-022-01402-2. PMID: 35410119
4. Saigi S. Prevalence and clinical characteristics of primary headache. J Child neurology. 2022; 37(12—14): 916—921 (in Russian). doi: 10.1177/08830738221048618. PMID: 36245416
5. Shtok V.N., Levin O.S. Handbook on the formulation of the clinical diagnosis of diseases of the nervous system. 3rd ed., reprint. and add. M.: MIA, 2019; 520 p. (in Russian).
6. Do T.P., Heldarskard G.F., Kolding L.T., Hvedstrup J., Schytz H.W. Myofascial trigger points in migraine and tension-type headache. J Headache Pain. 2018 Sep 10; 19(1): 84 p. doi: 10.1186/s10194-018-0913-8. PMID: 30203398
7. Galasso A., Urits I., An D., Nguyen D., Borchart M., Yazdi C., et al. A Comprehensive Review of the Treatment and Management of Myofascial Pain Syndrome. Curr Pain Headache Rep. 2020 Jun 27; 24(8): 43 p. doi: 10.1007/s11916-020-00877-5. PMID: 32594264
8. Antonaci F., Inan L.E. Headache and neck. Cephalalgia. 2021 Apr; 41(4): 438—442 doi: 10.1177/0333102420944878. PMID: 32727205
9. Steel S.J., Robertson C.E., Whealy M.A. Current Understanding of the Pathophysiology and Approach to Tension-Type Headache. Curr Neurol Neurosci Rep. 2021 Oct 2; 21(10): 56 p. doi: 10.1007/s11910-021-01138-7. PMID: 34599406
10. Gildir S., Tüzün E.H., Eroğlu G., Eker L. A randomized trial of trigger point dry needling versus sham needling for chronic tension-type headache. Medicine (Baltimore). 2019 Feb; 98(8): 14520 p. PMID: 30813155
11. Riddle E.J. Acupuncture Treatment for Chronic Tension-Type Headache. Neurology. 2022 Oct 4; 99(14): 1570—1572. PMID: 36192186
12. Olesiejuk M., Marusiak J., Chalimoniuk M. Myofascial Trigger Points therapy decreases myotonometric tone and stiffness of trapezius muscle, benefits headaches and muscle pain in migraine. NeuroRehabilitation. 2023; 52(2): 299—310. doi: 10.3233/NRE-220237. PMID: 36641690
13. Burris B.J., Bavarian R., Shaefer J.R. Nonsurgical Management of Temporomandibular Joint Arthropathy Dent Clin North Am. 2023 Jan; 67(1): 27—47. doi: 10.1016/j.cden.2022.07.003. PMID: 36404079
14. Xu M., Zhang X., He Y. An Updated View on Temporomandibular Joint Degeneration: Insights from the Cell Subsets of Mandibular Condylar Cartilage. Stem Cells Dev. 2022 Aug; 31(15—16): 445—459. doi: 10.1089/scd.2021.0324. PMID: 35044232
15. Zhulev E.N., Velmyakina I.V., Tyurina K.S. Influence of the level of psychoemotional tension on clinical manifestations of musculoskeletal dysfunction of the temporomandibular joint in young people. Modern problems of science and education. 2018; no.1: 52 p. (in Russian).
16. Azlag Pekince K., Caglayan F., Pekince A. Imaging of masseter muscle spasms by ultrasonography: a preliminary study. Oral Radiol. 2020 Jan; 36(1): 85—88. PMID: 30963482
17. Travell D.G., Simons D.G. Myofascial pain and dysfunction: A guide to trigger points. M.: Medicine. 2005; 1: 485—488 (in Russian).
18. Belova A.N. Scales, tests and questionnaires in neurology and neurosurgery: a guide for doctors and researchers (edited by D.D. Protsenko). M: Practical Medicine. 2018; 695 p. (in Russian).
19.Butova A.V., Silin A.V., Itskovich I.E. A method for determining the degree of morphological disorders of the musculoskeletal apparatus of the temporomandibular joints that occurred against the background of the long-term existence of musculotonic syndrome in patients with musculoskeletal dysfunction of the temporomandibular joints. Patent for an invention RU 2704466 C1, 28.10.2019. eLIBRARY ID: 41322922, EDN: JZFSRC
20. Barbero M., Schneebeli A., Koetsier E., Maino P. Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain. Curr Opin Support Palliat Care. 2019; Sep; 13(3): 270—276. PMID: 31313700
21. Charles D., Hudgins T., MacNaughton J., Newman E., Tan J., Wigger M. A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points. J Bodyw Mov Ther. 2019 Jul; 23(3): 539—546. doi: 10.1016/j.jbmt.2019.04.001. PMID: 31563367
22. Lew J., Kim J., Nair P. Comparison of dry needling and trigger point manual therapy in patients with neck and upper back myofascial pain syndrome: a systematic review and meta-analysis. J Man Manip Ther. 2021 Jun; 29(3): 136—146. doi: 10.1080/10669817.2020.1822618. PMID: 32962567
23. Nesterov A.M., Tsymbalov E.E., Nikulina M.A. Assessment of postural balance in the diagnosis and treatment of temporomandibular joint dysfunction. Health is the basis of human potential: problems and ways to solve them. 2022; 17, no.2: 1016—1022 (in Russian).
24. Solleveld H., Slaets B., Goedhart A., VandenBossche L. Associations of Masticatory Muscles Asymmetry and Oral Health with Postural Control and Leg Injuries of Elite Junior Soccer Players. J Hum Kinet. 2022 Nov 8; 84: 21—31. PMID: 36457464
25.Sergeev T.V., Agapova E.A., et al. A comprehensive study of the physiological reactions of the human body to complex postural effects. Medical Academic Journal. 2021; 21; no.4: 31—46 (in Russian).