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Repetitive episodes of muscle pain may sensitize the central nervous system resulting in progression of <jats:styled-content style=\"fixed-case\">TTH<\/jats:styled-content> to the chronic form. Thus, muscular factors may be responsible not only for the acute headache episode but also for chronification of the disorder. Simple analgesics and non\u2010steroidal anti\u2010inflammatory drugs are the mainstays of management of individual headache episodes. Ibuprofen 400\u00a0mg and aspirin 1000\u00a0mg are recommended as drugs of first choice based on treatment effect, safety profile and costs. Non\u2010pharmacological 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 <jats:styled-content style=\"fixed-case\">TTH<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Muscular factors play an important role in episodic <jats:styled-content style=\"fixed-case\">TTH<\/jats:styled-content>. 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