Conceptual analysis demonstrates coexisting nociceptive and nociplastic mechanisms in tension-type headache, highlighting the need for phenotype-targeted therapies.
Key Points
To propose a conceptual framework adapting International Association for the Study of Pain (IASP) classification criteria to categorize tension-type headache by underlying pain mechanisms.
Synthesized clinical findings evaluating peripheral trigger points and central pain sensitization patterns in tension-type headache.
Adapted standardized IASP mechanistic pain criteria to map nociceptive versus nociplastic phenotypes across headache severity and stages.
Tension-type headache manifests across a mechanistic spectrum where peripheral nociceptive inputs from trigger points coexist with central nociplastic pain processing.
Nociplastic mechanisms show greater predominance as headache transitions from episodic to chronic forms.
Interventions targeting only peripheral trigger points produce limited short-term relief, indicating that addressing central maladaptive processing is required for sustained efficacy.
Cite This Study
Cigarán-Méndez et al. (2026) studied this question.