Muscles and their role in episodic tension-type XXXX : implications for treatment.

@entity13705 @entity5018 @entity117 @entity2701 @entity10 @entity925
BACKGROUND AND OBJECTIVE: @entity2701 ( @entity2701 ) imposes a heavy burden on the global population but remains incompletely understood and poorly managed. DATABASES AND DATA TREATMENT: Here, we review current knowledge of peripheral factors involved in the mechanism of @entity2701 and make recommendations for the treatment of episodic @entity2701 based on these. RESULTS: Peripheral activation or sensitization of @entity13705 is most probably involved in the development of @entity925 and the acute episode of @entity2701 . Repetitive episodes of @entity925 may sensitize the central nervous system resulting in progression of @entity2701 to the chronic form. Thus, muscular factors may be responsible not only for the acute @entity10 episode but also for chronification of the disorder. Simple analgesics and non-steroidal anti-inflammatory drugs are the mainstays of management of individual @entity10 episodes. @entity5018 400  mg and @entity117 1000  mg are recommended as drugs of first choice based on treatment effect, safety profile and costs. Non-pharmacological therapies include electromyographic biofeedback, physiotherapy and muscle relaxation therapy. Future studies should aim to identify the triggers of peripheral nociception and how to avoid peripheral and central sensitization. There is a need for more effective, faster acting drugs for acute @entity2701 . CONCLUSION: Muscular factors play an important role in episodic @entity2701 . @entity5018 400  mg and @entity117 1000  mg are recommended as drugs of first choice.
