Skip to main content

Altered pain perception in children with chronic tension-type headache


Children with tension-type headache (TTH) might have an altered pain perception. Some of these children suffer from the chronic form of TTH. It is not yet known if central sensitization plays a role in chronification of TTH in children.


The aim of this study was to use stimulus-response functions for pressure versus pain to test the difference in pain perception between children 7-17 years of age with frequent episodic tension-type headache (FETTH), chronic tension-type headache (CTTH) and controls.


From May 2009-May 2011 we included 22 children with FETTH, 36 children with CTTH and 57 controls into this case-control study. We applied pressure of 5 increasing intensities to M. Trapezius and M. Temporalis respectively with a Somedic Algometer II. The child rated pain on a VAS-scale.

Statistical methods

Area under the curve (AUC) was calculated and represents the tenderness of the muscle. Whereas factor analysis showed that AUC represents only one dimension common for both muscles, an average AUC in each person was used as outcome variable in further univariate multiple linear regression analysis.


Stimulus-respons functions were different between the control group and CTTH. CTTH had a significant higher AUC (median 338, inter-quartile range (IQR) 180-406) than the control group (median 191, IQR 83-286) P<0.001. However AUC in the FETTH group (median 281, IQR 202-371) was not significantly different from either the control group (P=0.084) or CTTH (P=0.283), indicating that this group must represent an intermediate state between the two extreme groups. Sensitivity (AUC) did not change with increasing age, headache years, headache intensity, headache frequency or sex.


Pain perception for pressure versus pain in children with CTTH is altered. These changes seem to be a continuum of changes with the FETTH representing an intermediate state between controls and children with CTTH.

Author information

Authors and Affiliations


Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and Permissions

About this article

Cite this article

Soe, A., Thomsen, L., Tornoe, B. et al. Altered pain perception in children with chronic tension-type headache. J Headache Pain 14 (Suppl 1), P17 (2013).

Download citation

  • Published:

  • DOI:


  • Multiple Linear Regression
  • Intermediate State
  • Multiple Linear Regression Analysis
  • Central Sensitization
  • Pain Perception