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Clin J Pain. 2011 Jun;27(5):448-56. doi: 10.1097/AJP.0b013e318208c8fe.

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

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  • 1Departments of Clinical Neuroscience and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.



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.

[PubMed - indexed for MEDLINE]
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