Chronic tension-type headache

Chronic tension headaches are included in a group of headache syndromes as chronic daily headaches. Usual treatment includes oral medication, trigger point injections, and Botox. Patients can feel headache pain in different parts of their head. In this study a 45-year-old Japanese man reported having headaches for the past 20 years. He had visited a clinic then a hospital in the neurology department with diagnoses of suspected tension type headache and treatment unsuccessful. He then was referred to the rehabilitation medicine department for consultation. In his initial visit, they identified multiple muscle trigger points in his neck and his upper back. He was prescribed a lidocaine injection into the muscles in those areas and given herbal medicine. He also received 2000 extracorporeal shock wave therapy into those muscles. Cervical muscle and shoulder girdle stretches were recommended. At follow-up treatment visits they used extracorporeal shockwave therapy again on his neck muscles, which led to immediate pain relief. They didn't expect the treatment, including shockwave therapy to be successful at the first treatment in providing pain relief. In conclusion, using a combined treatment including extracorporeal shockwave therapy for chronic tension headache has shown results of pain relief for patient suffering with chronic tension headache. 

Takekawa T, et al, (2023) 17(1):478, Journal of Medical Case Reports, 

Multimodal treatment, including extracorporeal shock wave therapy, for refractory chronic tension-type headache: a case report 

https://pmc.ncbi.nlm.nih.gov/articles/PMC10617078/pdf/13256_2023_Article_4092.pdf