Deep Cervical Muscles and Functionality in Patients with Chronic Tension-Type Headache: An Observational Study

Abstract

Background and objectives: Chronic tension-type headache (TTH) is the type of headache with the highest prevalence. The involvement of musculoskeletal structures in TTH is supported by evidence in the scientific literature. Among these, deep cervical muscle strength appears to be related to the function of the cervical spine and the clinical characteristics of TTH. This study aimed to correlate anatomical, functional, and psychological variables in patients with TTH. Materials and methods: An observational descriptive study was carried out with 22 participants diagnosed with TTH for at least six months. The characteristics of headaches, including ultrasound-based deep neck flexor and extensor muscle thickness, range of motion (ROM), and pressure pain threshold (PPT), were recorded. We also conducted the Pain Vigilance and Awareness Questionnaire (PVAQ) and the Craniocervical Flexion Test (CCFT). Results: Moderate–large negative correlations were found between the PVAQ and the muscle thickness of right deep flexors contracted (r = −0.52; p = 0.01), left multifidus contracted (r = −0.44; p = 0.04), right multifidus at rest (r = −0.48; p = 0.02), and right multifidus contracted (r = −0.45; p = 0.04). Moderate–large positive correlations were found between the CCFT score and the left cervical rotation ROM (r = 0.53; p = 0.01), right cervical rotation ROM (r = 0.48; p = 0.03), muscle thickness of left multifidus contracted (r = 0.50; p = 0.02), and muscle thickness of right multifidus at rest (r = 0.51; p = 0.02). The muscle thickness of the contracted right deep cervical flexors showed a moderate negative correlation with headache intensity (r = −0.464; p = 0.03). No correlations were found between PPT and the rest of the variables analyzed. Conclusions: In patients with TTH, a higher thickness of deep cervical muscles was associated with higher ROM and higher scores in the CCFT. In turn, the thickness of deep cervical muscles showed negative correlations with pain hypervigilance and headache intensity. These results contribute to a better understanding of the physical and psychosocial factors contributing to the development of TTH, which is useful for implementing appropriate prevention and treatment measures.

Cervical impairments in subjects with migraine or tension type headache: an observational 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 ).…”

Effects of peripheral electromagnetic stimulation after an eccentric exercise-induced delayed-onset muscle soreness protocol in professional soccer players: a randomized controlled trial

“…These findings would indicate that the muscular responses that follow this type of acute exercises that cause DOMS were not altered by the treatment, since in both groups showed a decrease in performance in the measurements made in the post exercise/T2. The improvements observed in the PPT of the vastus medialis could have been influenced by other mechanisms, such as peripheral sensitization ( Amiri et al, 2021 ; García-Pérez-de-Sevilla et al, 2022 ).…”

Relationship between Self-Efficacy and Headache Impact, Anxiety, and Physical Activity Levels in Patients with Chronic Tension-Type Headache: An Observational Study

“…Headache duration (hours/day), intensity (from 0 (no pain at all) to 10 (the worst pain ever possible), and frequency (episodes per month) were measured following previous research [ 32 ].…”