Tension headache and parafunctions: the treatment with BoNTAs
Objectives: Tension-type headache (TTH) is a common disorder often associated with parafunctional activities such as bruxism, jaw clenching, and stress-related muscle hyperactivity. These parafunctions contribute to chronic muscle contraction, resulting in pain, discomfort, and functional impairment. Botulinum neurotoxins (BoNTAs) have emerged as a therapeutic option due to their ability to reduce muscle hyperactivity and modulate peripheral nociceptive pathways.
Introduction: Tension-type headache (TTH) is one of the most prevalent primary headaches, often triggered or worsened by parafunctional activities such as bruxism and jaw clenching. Chronic muscle hyperactivity contributes to persistent pain and functional limitations, highlighting the need for effective targeted therapies.
Materials / method: Patients with chronic TTH and documented parafunctions underwent treatment with BoNTAs. Injections were administered to affected muscles, including temporalis, masseter, and trapezius regions, based on clinical evaluation and pain mapping. Standardized dosing and injection protocols were followed, with follow-up assessments at 4, 8, and 12 weeks. Pain intensity, frequency of headache episodes, and parafunctional activity were evaluated using validated scales.
Results: BoNTAs treatment resulted in a significant reduction of headache frequency and intensity. Patients reported decreased parafunctional activity, including reduced jaw clenching and teeth grinding. Improvements were noted in functional measures such as range of mandibular motion and muscular tenderness. Adverse events were generally mild and transient, primarily localized to injection sites.
Conclusion: BoNTAs represent a safe and effective option for patients with tension-type headache associated with parafunctional behaviors. By targeting hyperactive muscles and modulating pain pathways, BoNTAs can improve both headache symptoms and associated parafunctions, enhancing overall quality of life. Further studies are needed to optimize dosing strategies and injection patterns for individualized treatment.
