Comparison of Pressure Pain Thresholds in Upper Trapezius and Temporalis Muscles Trigger Points Between Tension Type Headache and Healthy Participants: A Case–Control Study

Romero‐Morales, Carlos; Jaén-Crespo, Gonzalo; Rodríguez‐Sanz, David; Sanz‐Corbalán, Irene; López‐López, Daniel; Calvo‐Lobo, César

doi:10.1016/j.jmpt.2017.06.014

Cited by 12 publications

(16 citation statements)

References 35 publications

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“…After removing duplicates, 611 studies remained. Five hundred and eighty-seven (n = 587) were excluded based on examination of their title and/or abstract, leaving 24 articles (27–50), for full-text analysis. Three studies were excluded because they did not include a control group (40–42) and one because it had an experimental design (43).…”

Section: Resultsmentioning

confidence: 99%

Evidence of localized and widespread pressure pain hypersensitivity in patients with tension-type headache: A systematic review and meta-analysis

Fernández‐de‐las‐Peñas

Plaza‐Manzano

Navarro-Santana

et al. 2020

Cephalalgia

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Objective This meta-analysis evaluates pressure pain sensitivity values in symptomatic and distant pain-free areas comparing individuals with tension-type headache to controls. Databases and data treatment Electronic databases were searched for cross-sectional or prospective case-control studies comparing pressure pain thresholds in patients with tension-type headache to headache-free controls. Data were extracted by three reviewers. The methodological quality was assessed by the Newcastle-Ottawa Quality Assessment Scale. Meta-analyses of trigeminal, extra-trigeminal (neck) and distant pain-free areas in tension-type headache were compared to headache-free controls. Frequency of tension-type headache and gender were taken into account. Results Twenty studies were included. Patients with tension-type headache exhibited lower pressure pain thresholds than headache-free controls: Trigeminal (MD −49.11 kPa, 95% CI −66.05 to −32.17), cervical spine (MD −88.17 kPa, 95% CI −108.43 to −67.92) and distant pain-free areas (MD −98.43 kPa, 95% CI −136.78 to −60.09). Differences were significant for chronic, episodic, and mixed episodic and chronic tension-type headache within the trigeminal and neck (symptomatic areas), but only significant for chronic tension-type headache (MD −102.86, 95% CI −139.47 to −66.25 kPa) for distant pain-free areas. In general, women had lower pressure pain thresholds than men. The methodological quality ranged from fair (45%) to good (40%). The results showed a high heterogeneity and publication bias. Conclusion This first meta-analysis addressing pressure pain thresholds differences in symptomatic and distant pain-free areas between patients with tension-type headache and controls found low to moderate evidence supporting the presence of pressure pain hypersensitivity in the trigeminal and neck areas in tension-type headache in comparison with headache-free controls. Sensitivity to pressure pain was widespread only in chronic, not episodic, tension-type headache (moderate evidence). Registration number: https://doi.org/10.17605/OSF.IO/R29HY

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Section: Resultsmentioning

confidence: 99%

Evidence of localized and widespread pressure pain hypersensitivity in patients with tension-type headache: A systematic review and meta-analysis

Fernández‐de‐las‐Peñas

Plaza‐Manzano

Navarro-Santana

et al. 2020

Cephalalgia

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“… • There was a significant negative correlation between the number of trigger points (active or latent) and PPT. Romero-Morales (2017) [ 79 ] None 60 ETTH 60 CTRLs 38,30 ± 10,05 34 ± 8,20 Range not reported 24 M, 32F 27 M, 33F Not reported MTrP diagnosis was performed following the criteria described by Simons et al [ 19 ] PPT was assessed using an algometer. Temporalis and upper trapezius Minimum clinical differences in PPT between TTH and CTRLs were • Right upper trapezius; 0,85 kg/cm 2 • Left upper trapezius; 0;76 kg/cm 2 • Right temporalis; 0;16 kg/cm 2 • Left temporals; 0,17 kg/cm 2 Sohn (2012) [ 80 ] Examiner blinded to diagnosis 23 CTTH 36 ETTH 42 CTRLs 53.43 ± 16.97 51.11 ± 14.42 51.69 ± 16.18 Range not reported 2 M, 21F 7 M, 29F 8 M, 34F Headache intensity < 3 on a 10 cm VAS MTrP diagnosis was performed following the criteria described by Simons et al [ 19 ] and by Gerwin et al [ 89 ] FHP was used to evaluate posture abnormalities.…”

Section: Reviewmentioning

confidence: 99%

“…There is a high occurrence of active and latent MTrPs in patients with TTH [ 63 – 67 , 69 – 72 , 79 ] Active MTrPs are found almost only in TTH patients compared to controls [ 63 , 65 , 69 , 72 , 80 ]. MTrPs are more prevalent on the dominant side of the patients [ 66 ].…”

Section: Reviewmentioning

confidence: 99%

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Myofascial trigger points in migraine and tension-type headache

et al. 2018

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BackgroundA myofascial trigger point is defined as a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. It has been suggested that myofascial trigger points take part in chronic pain conditions including primary headache disorders. The aim of this narrative review is to present an overview of the current imaging modalities used for the detection of myofascial trigger points and to review studies of myofascial trigger points in migraine and tension-type headache.FindingsDifferent modalities have been used to assess myofascial trigger points including ultrasound, microdialysis, electromyography, infrared thermography, and magnetic resonance imaging. Ultrasound is the most promising of these modalities and may be used to identify MTrPs if specific methods are used, but there is no precise description of a gold standard using these techniques, and they have yet to be evaluated in headache patients.Active myofascial trigger points are prevalent in migraine patients. Manual palpation can trigger migraine attacks. All intervention studies aiming at trigger points are positive, but this needs to be further verified in placebo-controlled environments. These findings may imply a causal bottom-up association, but studies of migraine patients with comorbid fibromyalgia syndrome suggest otherwise. Whether myofascial trigger points contribute to an increased migraine burden in terms of frequency and intensity is unclear.Active myofascial trigger points are prevalent in tension-type headache coherent with the hypothesis that peripheral mechanisms are involved in the pathophysiology of this headache disorder. Active myofascial trigger points in pericranial muscles in tension-type headache patients are correlated with generalized lower pain pressure thresholds indicating they may contribute to a central sensitization. However, the number of active myofascial trigger points is higher in adults compared with adolescents regardless of no significant association with headache parameters. This suggests myofascial trigger points are accumulated over time as a consequence of TTH rather than contributing to the pathophysiology.ConclusionsMyofascial trigger points are prevalent in both migraine and tension-type headache, but the role they play in the pathophysiology of each disorder and to which degree is unclarified. In the future, ultrasound elastography may be an acceptable diagnostic test.

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“…Future studies should propose interventions in order to reduce kinesiophobia and pain intensity in patients with HV, such as myofascial pain interventions [53,54], neural mobilization techniques [55], or surgical procedures [47]. In addition, other outcome measurements should be evaluated in order to determine the influence of HV mechanical soft tissue properties on pain and kinesiophobia, such as myofascial trigger points evaluation [56], sonoelastography [57], pressure pain threshold [58], or thermography [59]. Finally and most importantly, an x-ray should be included in future studies as the gold stand, as well as ultrasound imaging could be used in advance to decline other possible pathologies [29].…”

Section: Future Studiesmentioning

confidence: 99%

Kinesiophobia and Pain Intensity Are Increased by a Greater Hallux Valgus Deformity Degree- Kinesiophobia and Pain Intensity in Hallux Valgus

Palomo‐López

Becerro-de-Bengoa-Vallejo

Iglesias

et al. 2020

IJERPH

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Background: Hallux valgus (HV) has been previously associated with psychological disorders. Thus, the purposes of this study were to associate kinesiophobia and pain intensity with HV deformity degrees, as well as predict kinesiophobia and pain intensity based on HV deformity and demographic features. Methods: A cross-sectional study was carried out recruiting 100 subjects, who were divided into HV deformity degrees, such as I-no HV (n = 25), II-mild (n = 25), III-moderate (n = 25), and IV-severe (n = 25) HV. Kinesiophobia total and domains (activity avoidance and harm) scores and levels were self-reported by the Tampa Scale of Kinesiophobia (TSK-11). Pain intensity was self-reported by the numeric rating scale (NRS). Results: Statistically significant differences (p < 0.01; η2 = 0.132–0.850) were shown for between-groups comparison of kinesiophobia total and domain scores (activity avoidance and harm) and levels, as well as pain intensity among HV deformity degrees. Post hoc comparisons showed statistically significant differences with a large effect size (p < 0.05; d = 0.85–4.41), showing higher kinesiophobia symptoms and levels and pain intensity associated with greater HV deformity degrees, especially for III-moderate and/or IV-severe HV deformity degrees versus I-no HV and/or II-mild deformity degrees. Both statistically significant prediction models (p < 0.05) for kinesiophobia (R2 = 0.300) and pain intensity (R2 = 0.815) were predicted by greater HV deformity degree and age. Conclusions: Greater kinesiophobia symptoms and levels and pain were associated with higher HV deformity degrees, especially severe and/or moderate HV with respect to no and/or mild HV. The kinesiophobia and pain intensity were predicted by greater HV deformity degree and age.

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Comparison of Pressure Pain Thresholds in Upper Trapezius and Temporalis Muscles Trigger Points Between Tension Type Headache and Healthy Participants: A Case–Control Study

Cited by 12 publications

References 35 publications

Evidence of localized and widespread pressure pain hypersensitivity in patients with tension-type headache: A systematic review and meta-analysis

Evidence of localized and widespread pressure pain hypersensitivity in patients with tension-type headache: A systematic review and meta-analysis

Myofascial trigger points in migraine and tension-type headache

Kinesiophobia and Pain Intensity Are Increased by a Greater Hallux Valgus Deformity Degree- Kinesiophobia and Pain Intensity in Hallux Valgus

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