Chronic tension headache ICD 10. Cephalgia. What to do in case of pathology

There are some diseases whose symptoms are known to the majority of the world's population. This includes tension headaches (TTH). It is the most common of all headaches. A constant course of this disease with varying frequency is observed in 20% of the general population. Women are diagnosed more often, which is associated with regular changes in hormonal levels due to menstruation. This headache is no less common in children than in adults.

Often, patients begin to treat the disease on their own, using various painkillers, sedatives, and anti-inflammatory drugs, which is not always justified.

The diagnosis of tension-type headache has ICD-10 code G44.2, it is designated as “tension-type headache” or “tension-type headache” (tension is translated as “tension”). Another unofficial name for this disease is vasomotor cephalgia.

Manifestations of the disease

Patients describe differently how tension headaches manifest. Its symptoms can be different:

• by nature it can be dull, diffuse, pressing and constricting, NOT pulsating;
• accompanied by increased fatigue, tiredness, irritability, decreased appetite, insomnia;
• appears on both sides of the head, sometimes asymmetrical;
• Its intensity is most often light and medium, but it can also be severe.

As a rule, the pain is not accompanied by vomiting, but mild nausea and intolerance to sounds and bright light may be present. Physical activity usually does not aggravate the condition, but it is difficult for the person to “pull together” and perform any action that requires effort. During a headache, you can feel some lumps when you feel the muscles of the neck and head. Neurological symptoms with this diagnosis are usually absent (loss of consciousness, impaired taste, tactile sensitivity, motor and oculomotor disorders, etc.).

Typically, pain is localized in the forehead, temples, and upper part of the head. Sometimes, along with this, tension in the head, neck and back of the head can be observed.

This condition does not carry with it any serious consequences for the patient, but experiencing regular discomfort and pain reduces the quality of his life. In addition, constant self-treatment with analgesics, which allow you to quickly get rid of an attack, negatively affects the functioning of internal organs, and in some cases causes mental or physical dependence.

Two types of HDN can occur:

• episodic;
• chronic.

Episodic headaches include experiencing painful sensations no more than 15 days a month with low intensity, and chronic tension headache means more than 20 days with higher intensity. This type of tension-type headache is often accompanied by clinical depression, generalized anxiety disorder, and neuroses.

Etiology of the disease

The main reasons that can cause tension in the head and pain:

1. Experiencing stress, depression, anxiety. With psycho-emotional stress, the headache usually begins in the afternoon, after or on the eve of important projects, exams, meetings.

Very often, such pain becomes a sign of hidden somatized depression, so attempts made by patients to relieve the attack with conventional analgesics do not help.

1. Prolonged muscle strain. This condition occurs when a person is forced to remain in a sedentary state for a long time (for example, at work). In this case, the affected neck, eye, scalp and shoulder muscles act as the cause of the headache.
2. Analgesics and tranquilizers that a person constantly takes in order to get rid of episodes of migraine or the same tension headache. This leads to chronicity of the disease and a change in the nature of pain. They begin to take on a constant background current of low intensity with periodic intensification. In this case, the tightening pain is replaced by a throbbing migraine. The effectiveness of treatment with these drugs begins to decline over time, which leads to an increase in dosages, and their cancellation causes increased pain.
3. Heavy diets, constant hunger, irregular and poor quality nutrition, dehydration. The drop in blood glucose that occurs during fasting inevitably leads to tension-type headache. Also, the activity of the hypothalamus, in which the centers of hunger and satiety are located, may play a role in the mechanism of pain during diets. People dependent on weather conditions, who often experience hunger, most often find themselves at risk when they begin to sharply limit themselves in food.
4. Chronic oxygen starvation of the brain. Occurs due to atherosclerosis, cardiovascular diseases, anemia, asthma, regular exposure to unventilated areas or at high altitudes (for example, in the mountains).

1. Hormonal changes in the body, which often trigger the mechanisms of tension headaches in women (menstruation, menopause) and in people of both sexes (with dysfunction of the thyroid gland, adrenal glands).
2. Caffeine abuse. Caffeine is often used in the treatment of headaches (part of analgesics) and can effectively relieve them, but in some patients, too much caffeine (for example, drinking too much coffee during the day) can be a trigger.

Speaking about muscle tension as something that can act as a cause of such pain, researchers note that it can act as a secondary factor, and the primary factor is depressive disorder and a state of nervous stress. Some doctors argue that the mechanism behind the appearance of headaches may be due to improper activity of pain filters located in the brain stem.

TTH can be a symptom of diseases such as:

• arterial hypertension or hypotension;
• dysfunction of the thyroid gland and adrenal glands;
• infectious colds;
• accompanied by an increase in body temperature.

There are risk factors that provoke tension in the head and the appearance of pain in people predisposed to them:

• changes in weather conditions;
• increased or decreased ambient temperature;
• smoking;
• alcohol intake and abuse;
• dehydration;
• lack of sleep;
• being in a stuffy room.

Treatment of the disease

Before treating such a headache, a neurologist must, firstly, exclude other types of headaches (cluster headaches, migraines, cervical osteochondrosis, increased intracranial pressure, tumors, temporomandibular joint syndrome), and secondly, identify possible diseases that caused pain (hypertension, neuroinfection, hypothyroidism, etc.). In order to differentiate the diagnosis, instrumental and laboratory tests are carried out, as well as consultations with other specialists (endocrinologist, cardiologist, infectious disease specialist, etc.).

In cases where tension-type headache is caused by somatic or infectious diseases and has very specific causes, treatment of the underlying pathology leads to the disappearance of pain or relief of the condition.

Since tension pain can be a manifestation of masked clinical depression, the patient should definitely consult a psychiatrist. Taking antidepressants when a diagnosis of a mood disorder is confirmed usually leads to resolution of tension-type headaches and prevention of attacks.

The patient is recommended to seek support from a psychotherapist, since treatment for clinical depression should involve not only the use of medications, but also a course of psychotherapy. The complex effect allows you to get rid of pain for a long time.

In other cases, treatment is difficult, but this does not mean that it should be absent. Some patients are helped by drugs that relieve spasms (for example, No-Spa) or muscle relaxants that reduce muscle tone.

If a woman’s tension headache is associated with the menstrual cycle or the onset of menopause, treatment with hormonal drugs, which is selected by a gynecologist, can help. However, it is worth noting that their use in some cases, on the contrary, can provoke attacks. In these cases, doctors recommend taking medications with reduced estrogen levels. All drugs are selected only by a specialist based on the results of the examination.

Some patients with tension-type headaches benefit from treatment with chiropractors, osteopaths, and reflexologists.

Methods for preventing attacks

A patient with TTH is recommended to analyze his lifestyle in order to identify the causes that trigger attacks. If pain occurs due to stress, the following recommendations may help get rid of it or alleviate the condition:

• avoiding traumatic situations as much as possible (also changing jobs or teams);
• consultations with a psychologist who, individually or in a group, will help to cope with standard situations that bring emotional distress;
• mastering relaxation methods (auto-training, aromatherapy, bathing, etc.);
• inclusion of effective ways to distract from negative situations (hobbies, communication with friends, animals).

When TTH appears especially often during a sedentary lifestyle, you should:

• introduce physical activity 3 to 5 times a week;
• take massage courses;
• include walks in the fresh air;
• During the day, if your work is sedentary, get up and move regularly.

If headaches occur during dieting, targeted weight loss is recommended:

• five meals a day (not the standard three meals a day) in small portions;
• the mandatory presence of dinner (it has been proven that people who refuse it suffer from night headaches);
• a balanced menu including all nutrients and microelements;
• presence of physical activity;
• drinking clean water at least 2 liters per day.

Tension headache is an unpleasant disease that can exhaust a patient, being present in his life from day to day or appearing in attacks many times a month. You should not endure discomfort, as the condition significantly reduces the quality of life. After the examination, the doctor can select the optimal treatment that will relieve attacks and prevent them.

Tension headache(TTH) is the most common form of headache. About a third of the population suffers from TTH. Frequency. In 60% of patients it first appears after 20 years. Onset after age 50 is atypical. Occurs more often in women.

Code according to the international classification of diseases ICD-10:

• G44.2

Classification. Episodic - usually associated with stressful situations of moderate intensity, goes away on its own and, as a rule, is relieved by widely used medications. The duration of attacks ranges from several minutes to several days. Chronic - daily, bilateral, usually occipital-frontal localization, associated with spasm of the muscles of the head and neck.

Causes

Etiology and pathogenesis. The combination of chronic emotional stress and muscle-tonic factor in conditions of imbalance of noci- and antinociceptive relationships. Uncomfortable position, incorrect posture. Frequent or prolonged stressful situations associated with anxiety and worry. Depression (in 70% of patients with chronic tension-type headache). Pathology of the cervical spine.

Genetic aspects. 40% of patients have a positive family history.

Risk factors. Obstructive sleep apnea. PM. Taking large amounts of caffeine.

Symptoms (signs)

Clinical picture. The headache appears gradually, during emotional stress it can occur suddenly and disappears within a few days or hours. The characteristics of the headache are bilateral, localized in the frontal-occipital region, both frontal lobes or diffuse, with a dull compressive character. Typically, patients describe their sensations figuratively (“..squeezing like a hoop”), and against the background of a constant feeling of compression or squeezing, prolonged episodes of dull, low-intensity pain occur. The patient experiences discomfort when combing his hair or wearing a hat. The pain does not stop even at night. Insomnia, difficulty concentrating. The pain is not aggravated by physical activity. When palpating the muscles, muscle compactions may be detected.

Diagnostics

Diagnostics. X-ray of the cervical spine. MRI or CT scan of the head if there are changes in the nature of the headache or pathological changes are detected during a neurological examination.

Treatment

TREATMENT

General principles. Ways to reduce the intensity of headaches.. Rest with a damp towel over the eyes in a dark room with good sound insulation, a warm shower or bath, massage of the posterior cervical and temporal areas.. Training in auto-training techniques.. Psychotherapy, hypnosis.. Postisometric muscle relaxation, acupuncture. It is necessary to try to change your lifestyle, to eliminate frequent or prolonged stressful situations. Doing relaxing exercises, aerobics, regular workouts.

Drug therapy. For an acute attack - NSAIDs. Naproxen 500 mg/day in 2 divided doses. Ibuprofen 400 mg/day in 3 divided doses. Ketoprofen 50 mg/day in 2 divided doses. For the prevention of chronic tension-type headache - TAD.. Amitriptyline at a dose of 50-100 mg/day.. Imipramine at a dose of 50-100 mg/day. In treatment-resistant cases, beta-blockers are prescribed in addition to antidepressants. Propranolol 80 mg daily. Nadolol 40 mg daily. Atenolol 50-100 mg daily.

Course and prognosis. In the presence of an unremovable long-term stressful situation, the process becomes chronic. Most cases of the disease are episodic in nature, do not significantly interfere with work and do not affect the quality of life.

Synonyms. Headache of muscle contraction. Tension cephalalgia. Stress headache. Idiopathic headache. Psychogenic headache. Muscle tension headache

Reduction. TTH - tension headache

ICD-10. G44.2 Tension type headache

Like everything in the world, diseases have not only classification, but also numbering. This is convenient for monitoring disease outbreaks, keeping strict records of visits to medical institutions with certain complaints, and, based on statistics, knowing what most often sends people to a hospital bed and causes death.

For all this, it was created, which in Russia acts as a single regulatory document. Cephalgia is also included in this list. Its ICD-10 code: R 51 Headache.

1 What causes the symptom

The usual reaction of most people: a headache, and the pain went away, everything was forgotten. But no, the problem remains, because, as thousands of examples have proven, cephalgia mainly occurs as a consequence of some disease, often completely unrelated to the head.

• hypertension, intracranial pressure;
• cardiovascular problems;
• neuralgia and osteochondrosis;
• heavy load, especially on vision;
• nervous overstrain;
• lack of routine and systematic lack of sleep;
• head injuries and inflammations;
• inflammation of internal organs and diabetes.

2 Clinical picture of the disease

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It is impossible to confuse a headache with any other. Basically, even regardless of the reasons, it has an increasing tendency, nausea and vomiting begin, and perspiration appears on the forehead. A person has difficulty perceiving bright light and sounds and becomes irritable.

1. The type of pain is vascular cephalgia. Its cause is the narrowing or expansion of blood arteries, which experienced unexpected irritation and reacted by sending pain signals. An unexpected load falls on the vessels of the brain, not designed to accept a large amount of blood, so patients characterize their perception as pain of a pulsating nature. This is how vegetative-vascular dystonia makes itself felt, but hypertension or hypotension also have similar symptoms. When the blood volume is large and the tension of the muscle tissue located in the walls of the canals is low, the speed of venous blood in the cranium slows down and its volume decreases. This is where the pain arises. Sometimes this type of pain can be provoked by external causes, if a person keeps his head down for too long or tightens his throat too much with tight clothes.
2. Venous cephalalgia is caused by weak tension in the walls of the venous canals; as a result, the blood volume increases, as does the pressure, and the intracranial veins are forced to stretch, and the person experiences pain in the back of the head. There is another reason: if a hemorrhagic failure occurs and the blood becomes too thick, due to the loss of elasticity of the red blood cells, the coagulant activity of the plasma increases. Oxygen is not supplied in usual quantities, toxins remain, and a dull pain relentlessly torments, sometimes becoming unbearable, sometimes subsiding, but the severity remains. Ringing and noise in the ears appear, movements slow down.
3. Vasomotor cephalgia. The head, as if during a sophisticated torture, is tightly clamped in a vice. The pain does not go away and causes nausea. Usually the culprits are low mobility, nervous shock, excess medications, heavy strain on the neck and shoulders, and staying in a stuffy, often smoky room.
4. When a spasm of muscle tissue occurs, the blood flow can either be completely stopped, or partially, which means that toxins are not washed out of the body, beginning their toxic effect, which is one of the causes of pain, which can develop into chronic pain over time without treatment . Tension cephalalgia is most often felt in the occipital region, spreading throughout the head. Patients complain of the sensation of a hot hoop that cannot be removed.
5. The autonomic nervous system can be affected for various reasons. Stagnation and disturbances of blood flow, injuries, inflammation, stress, alcohol - any shock can disrupt the functioning of many body systems, and vegetative-vascular dystonia provoked in this way can cause a special dull, compressive pain. And if the pressure is increased, the heart often begins to hurt, and respiratory functions are impaired.
6. Angiodystonic cephalalgia. Headaches also occur when blood pressure rises and the blood vessels in the brain begin to narrow, and the veins become deformed due to improper blood flow. This is a dangerous condition, as it often leads to a heart attack and cerebral hemorrhage. The pain with this type of cephalgia is pulsating in nature, localized in the back of the head, but can spread to the entire head. Attacks are especially dangerous after vigorous physical activity.

3 What to do in case of pathology

• Presses the head and eyes or “hits the back of the head with a sledgehammer” or knocks in the temples

Other headache syndromes (G44)

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

ICD code for cephalalgia

Short description

Causes

Symptoms (signs)

Diagnostics

Tension headache - description, causes, symptoms (signs), diagnosis, treatment.

Short description

Tension headache (TTH) is the most common form of headache. About a third of the population suffers from TTH. Frequency In 60% of patients, it first appears after 20 years. Onset after 50 years is atypical. It occurs more often in women.

Causes

Genetic aspects. 40% of patients have a positive family history.

Risk factors Obstructive sleep apnea Drugs Ingesting large amounts of caffeine.

Symptoms (signs)

Diagnostics

Diagnosis X-ray of the cervical spine MRI or CT scan of the head if there are changes in the nature of the headache or pathological changes are detected during a neurological examination.

General principles Ways to reduce the intensity of headaches Rest with a damp towel over the eyes in a dark room with good sound insulation, warm shower or bath, massage of the posterior cervical and temporal areas Training in auto-training methods Psychotherapy, hypnosis Postisometric muscle relaxation, acupuncture It is necessary to try to change your lifestyle, eliminate frequent or prolonged stressful situations Performing relaxing exercises, aerobics, regular exercise.

Course and prognosis In the presence of an irreparable long-term stressful situation, the process becomes chronic. Most cases of the disease are episodic in nature, do not significantly interfere with work and do not affect the quality of life.

Synonyms Muscle contraction headache Tension cephalalgia Stress headache Idiopathic headache Psychogenic headache Muscle tension headache

Reduction. TTH - tension headache

ICD-10 G44.2 Tension type headache

Cephalgia

Classification of cephalgia

• neuralgic;
• infectious-toxic;
• liquorodynamic;
• vasomotor (tension);
• vascular.

Symptoms

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ICD 10 code cephalalgia

ICD-10 code for cephalalgia and signs of the disease

1 What causes the symptom

Headache occurs due to:

But this is not a complete list of diseases that cause headaches.

2 Clinical picture of the disease

Cephalgia has varieties, thanks to which it is possible to identify a disease that at first glance is not associated with headache.

Constant pain can turn into chronic cephalgia, and the causes of this pathology can be the most unexpected.

Basically, these are hormonal imbalances, too busy work schedules, nervous breakdowns, and medications.

3 What to do in case of pathology

When the headache does not go away even after taking analgesics, and intensifies, doctors determine that this is persistent cephalgia. With this form, it is necessary to study the entire body, here modern devices come to the rescue, and, having identified the cause, it will be possible to treat the patient.

Headaches can occur when temperatures change due to climatic conditions, or can be a hereditary factor.

It is life-threatening if the headache is associated with meningitis, when swelling occurs in the meninges.

Headaches can have many causes, and you need to respond to the fact that cephalgia has occurred in a timely manner.

• You suffer from occasional or regular headaches
• Do you sometimes feel nauseous and dizzy when you have a headache?
• Everything starts to irritate me, it becomes impossible to work!
• Do you take out your irritability on your loved ones and colleagues?

Stop putting up with this, you can’t wait any longer, delaying treatment. Read what Elena Malysheva advises and find out how to get rid of these problems.

ICD code: G44

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In medicine, there are many types of headaches, susceptible and insensitive to pain syndrome. The ICD 10 code for cephalalgia refers to R51.

This excludes such syndromes as:

• migraine;
• atypical facial pain;
• trigeminal neuralgia.

Moreover, most of R51’s ailments relate to the facial part of the head. The international directory contains detailed information about the patient’s diagnosis without unnecessary description of all its components.

Classification of cephalgia

According to the results of the study, experts identified five main types of cephalgia. They manifest themselves in various forms and have their own pain syndrome code in ICD 10. Pathology classifies cephalalgia according to the type of its effect on the body:

• neuralgic;
• infectious-toxic;
• liquorodynamic;
• vasomotor (tension);
• vascular.

Moreover, each form of the disease has a different effect on the body. Depending on the type of pain, the patient exhibits various symptoms.

Symptoms

Since the types of disease affect the body to varying degrees, it is worth examining in detail the main manifestations of the disease for each of them:

• Neuralgic cephalgia. A fairly common form of manifestation of the disease. It is characterized by sharp and acute attacks that manifest themselves due to physical impact: shaving, chewing, washing, etc.
• Infectious-toxic. In this case, the cause is a virus or bacteria introduced into the body. To eliminate the negative factor, the body uses the immune system, resulting in destruction with the further spread of toxic elements. They are the ones that cause long-lasting pain.
• Liquorodynamic. A common type of cephalalgia among older people. It is formed as a result of increased intracranial pressure. The unpleasant throbbing pain may become stronger and subsides over time. Among young people, such an illness can be caused by a complication of the disease or external factors.
• Vasomotor. An active lifestyle or daily stress in the gym causes excessive muscle tension. They create a monotonous pain syndrome of medium intensity. Patients experience a sensation of squeezing or squeezing of the head. It is observed mainly in the frontal or occipital part of the head. In the ICD, tension headache is designated as a common headache by code R
• Vascular. Excessive disorder leads to vasodilation and large volumes of blood flowing throughout the body. Patients with such syndromes experience pain comparable to sharp blows inside the skull. Squeezing the adductor artery allows you to get rid of unfavorable sensations.

Primary formation of the disease is easy eliminated with the help of available analgesics. However, they do not cure, but only dull the pain. You can completely get rid of cephalalgia only with the help of an appropriate course of treatment. To create it, you will need to consult a doctor to make an accurate diagnosis, select the optimal medications and prescribe the appropriate set of procedures.

Diet and lifestyle changes are no less important, since in most cases they are the cause of pain in the head.

Headache - Head pain of varying severity caused by various reasons. Most often observed in women over 20 years of age. The risk factor is stress, genetics does not matter.

About 7 out of 10 people have a headache every year. In most cases, headaches last a few hours, but some forms of pain can persist for weeks.

Only one part of the head may hurt, for example, above the eyes, or the pain may be felt throughout the entire head. The characteristics of the pain can be very different, it can be constant and dull, or sudden and sharp.

There are many reasons headache, which determine its localization and character. In about 3 out of 4 cases headache causes tension in the muscles under the scalp or neck muscles. Headache tension tends to recur frequently, is of moderate severity and is felt on both sides of the head. For other forms headache such as migraines or histamine headache, there could be many reasons.

Only in rare cases headache causes serious illness that requires immediate medical attention.

For example strong headache may be a symptom of meningitis, a condition caused by an infection of the lining of the brain and spinal cord. Also the reason headache there may be hemorrhage in the subarachnoid space, when blood accumulates between the membranes of the brain. In older people headache, accompanied by soreness of the scalp or temples, may be the result of temporal arteritis, in which the temporal arteries become inflamed.

In some cases headache is a consequence of prolonged use of strong drugs.

If strong headache lasts more than 12 hours or is accompanied by other symptoms such as blurred vision or vomiting, you should consult a doctor immediately. A general inspection will be carried out. If the doctor suspects the cause of the disorder causing headache, then the patient needs to have a computed tomography or magnetic resonance scan of the brain. Treatment depends on the cause headache. For example, it usually goes away after rest and administration. Migraine and histamine headache need to be treated with special medications based on (for example sumatriptan).

Headache in children - headaches of varying intensity, which may be associated with existing diseases. Occurs more often in school-age children. Risk factors depend on the cause of the disease.

Headache quite common among children. 9 out of 10 children complain about headache. Usually headache is only a temporary discomfort, but if it is too strong or repeated frequently, it may indicate an existing disease. In this case, immediate treatment is required.

Young children, especially those under 5 years old, often cannot accurately indicate the location of pain. They may complain about headache when their teeth or ears actually hurt.

Headache It can have various causes in children, most of which are not serious. In older children, headaches usually have the same causes as in adults. However, if a child has a serious illness such as meningitis (inflammation of the meninges) or a brain tumor, parents will understandably be concerned. Headache It is extremely rare for children to be associated with these two diseases, but parents should be aware of the dangerous symptoms in order to seek medical help in time.

Short-term headache in children may occur due to viral infections, such as colds. Such infections usually clear up within a few days and do not require treatment. Schoolchildren often suffer from this. Such pain usually occurs during the day, lasts no more than 24 hours, and may be associated with emotional stress at school or at home. Sometimes the reason headaches There may be vision problems, such as myopia. By the age of 15, every 20th child will experience at least one migraine attack.

The child has a strong headache accompanied by vomiting or drowsiness, requires immediate medical attention. If, after a head injury, a child loses consciousness even briefly, you should immediately take him to the clinic.

If parents suspect that their child is suffering from stress, they should try to determine the cause. If a child suffers from frequent headaches without an obvious cause, a medical examination is necessary.
If the medical examination reveals no cause for concern, further examination is not necessary. If meningitis is suspected, the child should be hospitalized immediately. In some cases, a CT or MRI scan of the brain may be needed to diagnose an injury or tumor. If the child is completely healthy, but suffers from frequent headaches, consultation with an ophthalmologist is necessary, because it is necessary to exclude possible vision problems.