Studies

Chronic Tension Type Headache and the Impact of Myofascial Trigger Point Release in the Short Term Relief of Headache 

Abstract 

Tension-type headache (TTH) is a widespread and major health concern. The one-year prevalence of episodic and chronic tension-type headache is 38% and 2-3%, respectively. Tension-type headache affects daily functioning, resulting in limitations in performance and participation. Myofascial trigger points (MTrPs) are focal disruptions in skeletal muscle that can refer pain to the head and reproduce the pain patterns of tension-type headache (TTH). 

In recent years the myofascial trigger point (MTrP) has become a site of interest in the pathology of TTH. Patients with TTH exhibit increased presence and tenderness of MTrPs in pericranial muscles. There is evidence to suggest that the presence and pain sensitivity of MTrPs are sufficient to make distinctions between headache and non-headache populations. MTrPs within skeletal muscle are characterized by a number of physical features including a palpable tender nodule within a taut muscular band, point tenderness at the nodule, characteristic patterns of referred pain and the presence of a local twitch response when stimulated.   

While pathogenesis of TTH remains unclear and is likely multifactorial, MTrPs have an intriguing connection to TTH in that active MTrPs can elicit referred pain phenomenon that reproduce patient pain complaints, thus providing a direct connection between peripheral tissue and the central pain of headache. In recent years, interventions directed at a MTrP have led to reduction in local pain, referred pain intensity, and the extent of referred pain fields originating from the MTrP in both headache and non-headache populations.

Purpose: This study investigated the effect of myofascial release in relieving the symptoms of Chronic Tension Type Headache (CTTH) 

Methods: The study used a convenience sampling pretest-post test design. 31 people (7 men and 24 women, age range 18-58 years, mean age 32 years) with CTTH participated in the study. The headache sample was screened for MTrP in the cranial and pericranial muscles and was treated with myofascial release therapy. The outcomes were measured in terms of the number of headache days in a week and the headache pain level measured in visual analog scale (VAS). Analysis: The analysis was done using paired ‘t’ test at 95% confidence interval 

Results: The study showed significant improvements in reduction of the number of headache days (p < 0.001) and the headache pain level (p < 0.001) following treatment. 

Conclusion and Implications: Myofascial release therapy to the trigger points in people with CTTH has a positive influence in decreasing pain intensity and frequency in CTTH sufferers. In future, during management of CTTH screening for myofascial trigger points and concomitant treatment using myofascial release could be considered. 

Keywords: Chronic Tension Type Headache, Cranial muscles, Pericranial muscles, Myofascial trigger point, Referred pain, Myofascial pressure release 

Link To Study

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