Pain sensitization and atrophy of deep cervical muscles in patients with chronic tension-type headache

Muñiz, José Ángel del Blanco; Flor, Ángel González de la; Balmaseda, Diego Domínguez; Vera, Daniel Martín; Sierra, Alberto Sánchez; Sevilla, Guillermo García Pérez de

doi:10.1590/1806-9282.20230841

Cited by 2 publications

(1 citation statement)

References 20 publications

(24 reference statements)

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“…Significant differences in muscle thickness were observed between the pathological groups and the group of healthy subjects in this study. Previous studies have demonstrated the association between TTH and a reduction in muscle thickness in the multifidus and longus colli muscles ( 27 ). Positive correlations were found between craniocervical flexion test (CCFT) performance and multifidus thickness, along with negative correlations between deep cervical muscles thickness and pain intensity in these patients ( 28 ).…”

Section: Discussionmentioning

confidence: 96%

Cervical impairments in subjects with migraine or tension type headache: an observational study

del Blanco Muñiz,

Sánchez Sierra,

Ladriñán Maestro

et al. 2024

Front. Neurol.

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ObjectiveThe aim of this investigation was to compare the thickness of the deep local muscles in the neck region, as well as local and widespread sensitivity and functionality, between individuals with migraine, Tension-Type Headache (TTH), and healthy controls. To date, we know that the onset of migraine and TTH share similar pathophysiological pathways. Nevertheless, there may be some anatomical and functional differences which would explain why clinicians may obtain variable results when treating both pathological entities with similar or equal approaches.MethodsAn observational study was conducted in accordance with STROBE guidelines. The flexor longus colli and multifidus, two neck-stabilizing muscles, were measured using B-mode ultrasound imaging. The upper trapezius, masseter, temporalis, tibialis anterior, and median nerve all underwent bilateral pressure-pain threshold (PPT) assessments.ResultsNinety participants were enrolled in the study. All subjects were equally divided into TTH, migraine and control groups. The PPT values exhibited lower thresholds in patients with TTH than both migraine and healthy participants. Specifically, in the temporal muscle on both sides, patients with TTH exhibited a significantly lower threshold (p < 0.001)than both migraine and healthy participants. Patients with TTH displayed significantly lower thresholds in both upper trapezius muscles (right: p < 0.001; left: p = 0.001). Similar results were obtained for the tibialis anterior PPTs from both sides (p = 0.001 in both). However, both clinical groups exhibited lower thresholds than the healthy subjects (p < 0.001). In multifidus muscle cross-sectional area (CSA), no statistically significant differences were found between migraine patients and healthy subjects, both in relaxation and contraction (right; p > 0.05 and p > 0.05; left: p > 0.05 and p > 0.05). However, patients with TTH exhibited a smaller CSA than both migraine patients and healthy controls in multifidus relaxed and contracted state (right: p < 0.001 in both relaxed and contracted multifidus; left: p = 0.001 and p < 0.001, respectively). Similar results were obtained for the left longus colli muscle in both relaxation and contraction for patients with TTH and migraine compared with healthy subjects (p = 0.001 and p < 0.001, respectively, for muscle relaxation and p < 0.001 for muscle contraction). However, no significant differences were observed between patients with TTH and migraine (p < 0.05 in both relaxation and contraction). In the right longus colli, TTH and migraine patients had a significantly smaller CSA during contraction than healthy subjects (p < 0.001 in both comparisons). In the craniocervical flexion test, both groups of patients with TTH and migraine showed significantly lower values than healthy subjects (p < 0.001 in both comparisons). However, no significant differences were found between patients with TTH and migraineurs (p > 0.05).ConclusionThe findings provide a significant message for clinicians since anatomical and functional impairments were shown in patients with TTH and migraine. This study corroborates a lack of strength and smaller CSA in both clinical groups compared to controls. Therefore, strengthening programs may be addressed successfully for people with these pathological entities. To be more accurate, according to PPTs and CSA lower values in patients with TTH compared to migraine and controls, manual therapy approaches to desensitize craniocervical soft tissues and exercise therapy to increase endurance of deep cervical muscles may become meaningful especially in subjects with TTH. Nevertheless, in order to distinguish precisely between patients with TTH and migraine, different diagnostic strategies may be used in the future to describe these populations in further detail, which will assist health professionals in a more accurate treatment selection.

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Section: Discussionmentioning

confidence: 96%

Cervical impairments in subjects with migraine or tension type headache: an observational study

del Blanco Muñiz,

Sánchez Sierra,

Ladriñán Maestro

et al. 2024

Front. Neurol.

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Evaluation of Abdominal Musculature Thickness, Pelvic Tilt, and Trunk Mobility in Women with Primary Dysmenorrhea: A Cross-Sectional Observational Study

del Prado-Álvarez,

Estrada-Barranco,

González-de-la-Flor

et al. 2024

JCM

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Background: This cross-sectional observational study aimed to investigate differences in abdominal musculature thickness, pelvic tilt, and trunk mobility between women with primary dysmenorrhea (PD) and a control group (CG). Methods: Participants included 44 women (22 with PD and 22 controls) aged over 18, nulliparous, and of reproductive age. Ultrasound imaging was used to measure the thickness of the transverse abdominis (TrA), internal oblique (IO), external oblique (EO), and rectus abdominis (RA) muscles at rest and during contraction. Additionally, anterior pelvic tilt was assessed using the Palpation Meter (PALM), and trunk flexion and extension were measured using an accelerometer (activForce2). Results: Significant differences (p < 0.05) were found in RA and EO muscle thickness, with lower values in the PD group compared to CG. However, there were no significant differences (p > 0.05) in TrA and IO muscle thickness, anterior pelvic tilt, or trunk mobility between groups. Conclusions: These findings contribute to understanding the musculoskeletal factors potentially involved in dysmenorrhea. Further research is needed to explore associations between PD and structural and alignment parameters.

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Pain sensitization and atrophy of deep cervical muscles in patients with chronic tension-type headache

Cited by 2 publications

References 20 publications

Cervical impairments in subjects with migraine or tension type headache: an observational study

Cervical impairments in subjects with migraine or tension type headache: an observational study

Evaluation of Abdominal Musculature Thickness, Pelvic Tilt, and Trunk Mobility in Women with Primary Dysmenorrhea: A Cross-Sectional Observational Study

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