Subjective well-being in patients with chronic tension-type headache: effect of acupuncture, physical training, and relaxation training

• Published in: The Clinical journal of pain Vol. 27; no. 5; p. 448
• Main Authors: Söderberg, Elisabeth I, Carlsson, Jane Y, Stener-Victorin, Elisabet, Dahlöf, Carl
• Format: Journal Article
• Language: English
• Published: United States 01.06.2011
• Subjects: Acupuncture Analgesia - methods; Acupuncture Therapy; Adolescent; Adult; Aged; Chronic Disease; Exercise Therapy - methods; Female; Humans; Male; Middle Aged; Pain Measurement; Quality of Life; Relaxation Therapy - methods; Tension-Type Headache - diagnosis; Tension-Type Headache - therapy; Treatment Outcome; Young Adult
• ISSN: 1536-5409
• DOI: 10.1097/AJP.0b013e318208c8fe

Episodic tension-type headache is a common problem affecting approximately 2 of 3 of the population. The origin of tension-type headache is multifactorial, but the pathogenesis is still unclear. In some individuals episodic tension-type headache transforms into chronic tension-type headache (CTTH). Subjective symptoms related to the central nervous system might affect patients subjective well-being and quality of life. This study compared 3 nonpharmacologic treatments; acupuncture, relaxation training, and physical training on subjective well-being in patients with CTTH. Ninety consecutive patients with CTTH were randomly allocated to acupuncture, relaxation training, or physical training. At baseline 88 age-matched and sex-matched healthy controls were compared with the patients with CTTH. Subjective, central nervous system-related symptoms that might affect patients' subjective well-being and quality of life were assessed with the Minor Symptom Evaluation Profile, which contains 24 self-administered standardized items with visual analog scale responses. Fifteen items are categorized into 3 dimensions: contentment, vitality, and sleep. Assessments were made before treatment, immediately after, and 3 and 6 months after the last treatment. Baseline values of the total score of the 24 items and the 3 dimensions were generally lower in patients with tension-type headache compared with the reference group. No significant differences were found among the 3 treatment groups during the baseline period. All treatments proportionally improved the subjective, central nervous system-related symptoms in patients with CTTH. The 3-month follow-up, the total score of the Minor Symptom Evaluation Profile was significantly improved in the physical training group compared with the acupuncture group (P=0.036). Total mean over period was also highest in the physical training group compared with the acupuncture group (P=0.025). The vitality and sleep dimension was significantly improved at the 6-month follow-up in the relaxation training group compared with the acupuncture group (P=0.04). Physical training and relaxation training seem to be preferable nonpharmacologic treatments for improvement of central nervous system-related symptoms and subjective well-being for patients with CTTH.