Myofascial trigger points in children with tension-type headache: a new diagnostic and therapeutic option?

Stülpnagel, Celina von; Reilich, Peter; Schäfer, J.; Blaschek, Astrid; Lee, S. H.; Henschel, Volkmar; Mansmann, Ulrich; Heinen, Florian

doi:10.1055/s-2006-974105

Cited by 4 publications

(14 citation statements)

References 9 publications

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“…These girls received TrP treatment twice per week. After 6.5 sessions, the headache frequency was reduced by 67.7%, the intensity by 74.3% and the mean duration by 77% [50]. In these studies, manual therapies were applied to inactive TrPs.…”

Section: Trigger Point Manual Therapy For Tension-type Headachementioning

confidence: 99%

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Muscle trigger point therapy in tension-type headache

Alonso‐Blanco

de-la-Llave-Rincón

Fernández‐de‐las‐Peñas

2012

Expert Review of Neurotherapeutics

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Recent evidence suggests that active trigger points (TrPs) in neck and shoulder muscles contribute to tension-type headache. Active TrPs within the suboccipital, upper trapezius, sternocleidomastoid, temporalis, superior oblique and lateral rectus muscles have been associated with chronic and episodic tension-type headache forms. It seems that the pain profile of this headache may be provoked by referred pain from active TrPs in the posterior cervical, head and shoulder muscles. In fact, the presence of active TrPs has been related to a higher degree of sensitization in tension-type headache. Different therapeutic approaches are proposed for proper TrP management. Preliminary evidence indicates that inactivation of TrPs may be effective for the management of tension-type headache, particularly in a subgroup of patients who may respond positively to this approach. Different treatment approaches targeted to TrP inactivation are discussed in the current paper, focusing on tension-type headache. New studies are needed to further delineate the relationship between muscle TrP inactivation and tension-type headache.

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Section: Trigger Point Manual Therapy For Tension-type Headachementioning

confidence: 99%

“…A case series including nine girls (aged 13 years) with tension-type headache suggested that TrPs can play an additional role in a subgroup of children with this headache [50]. These girls received TrP treatment twice per week.…”

Section: Trigger Point Manual Therapy For Tension-type Headachementioning

confidence: 99%

Muscle trigger point therapy in tension-type headache

Alonso‐Blanco

de-la-Llave-Rincón

Fernández‐de‐las‐Peñas

2012

Expert Review of Neurotherapeutics

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“…A case series of nine 13-year-old girls with TTH suggested that TrPs play an important role in at least a subgroup of children with TTH [39]. In a posterior blindedcontrolled study, we observed that children with chronic TTH exhibited active TrPs in the same muscles than adults such as s u b o c c i p i t a l , t e m p o r a l i s , u p p e r t r a p e z i u s a n d sternocleidomastoid [40].…”

Section: Trigger Points In Tension-type Headache Epidemiological Studiesmentioning

confidence: 99%

Myofascial Head Pain

Fernández‐de‐las‐Peñas

2015

Curr Pain Headache Rep

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Muscle nociception is mainly characterized by local tenderness and referred pain. The neurophysiological basis of muscle pain supports a role of sensitization mechanisms. From a clinical viewpoint, muscle pain is represented by the presence of myofascial trigger points (TrPs). Evidence suggests that TrPs are able to start a peripheral nociceptive mechanism and hence contributing to changes in the central nervous system. Several studies demonstrated that the referred pain elicited by TrPs reproduces the headache pattern in patients with tension-type headache (TTH), migraine, cervicogenic headache and, in some individuals, with cluster headache. In fact, sensitization of nociceptive pain pathways in the central nervous system due to prolonged nociceptive stimuli from TrPs seems to be responsible for the conversion of episodic to chronic TTH. In other headaches, TrPs may be able to stimulate the trigeminal nucleus caudalis and hence triggering a migraine or cluster headache attack. Proper treatment directed towards TrP inactivation has documented positive effects in individuals with these headaches; however, longitudinal studies are needed to further determine the role of TrPs in head pain.

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“…(3,12) There is suggestion this may be achieved by interrupting nociceptive stimulus and changing sensory input-for example, by using the contextual factors of light stroking or massage. (12,14) Many successful treatment strategies for CTTH appear to have used neuromuscular therapy (NMT); incorporating stretch techniques, massage, and TrP release (TPR). (3,12,14,15) Muscles identif ied with a high presence of TrPs in cases of CTTH are upper trapezius, suboccipitals, sternocleidomastoid (SCM), temporalis, and superior oblique ocular muscles.…”

Section: Client Selectionmentioning

confidence: 99%

“…(12,14) Many successful treatment strategies for CTTH appear to have used neuromuscular therapy (NMT); incorporating stretch techniques, massage, and TrP release (TPR). (3,12,14,15) Muscles identif ied with a high presence of TrPs in cases of CTTH are upper trapezius, suboccipitals, sternocleidomastoid (SCM), temporalis, and superior oblique ocular muscles. (3,12,13,14) Other muscles identified have been levator scapula, semispinalis, splenius capitis, frontalis, and occipitalis.…”

Section: Client Selectionmentioning

confidence: 99%

Remedial massage therapy interventions including and excluding sternocleidomastoid, scalene, temporalis and masseter muscles for Chronic Tension Type Headaches: A case series.

Shields

Smith

2020

IJTMB

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This 6-week case series addressed four cases of chronic tension-type headache (CTTH) to investigate whether massage therapy interventions were more effective when muscles of the anterior neck, jaw and cranium were included. Four female clients suffering CTTH received six pre-determined massage therapy interventions, 45 minutes each, over a three week period. Case A and B (exclusion cases) received interventions addressing shoulder, posterior neck and occiput muscles, Case C and D (inclusions cases) received interventions addressing the same areas and sternocleidomastoid, scalene, temporalis and masseter muscles. Treatment strategies included myofascial trigger point release, neuromuscular therapy, and consideration of central sensitization mechanisms present in CTTH. Outcome measures of headache frequency (primary), intensity, and duration (secondary) were recorded via headache diaries issued to each participant for one week of baseline measures, 3 weeks of intervention, and a two-week runout period. Secondary measures also included a headache disability inventory (HDI) at baseline, conclusion of intervention and final measures. After final measures, clients were given stretching education and 4 weeks later, a follow-up phone conversation to note subjective headache reports. Results showed all cases had headache frequency and HDI score reductions, while intensity and duration measures fluctuated. At final measures, exclusion Case A and both inclusion cases (C and D) had headache frequency reductions to below CTTH diagnostic criteria from The International Headache Society (>15 headache affected days /month). These three cases also had clinically meaningful (>16%) HDI score reductions and subjectively reported continued improvements after study completion. Comparative results suggest there may be additional benefit in reducing headache frequency and disability with the inclusion of anterior neck, jaw and cranial muscles in the treatment of CTTH. The inclusion cases overall had a greater decrease in headache frequency and HDI, however, limited sample size makes it difficult to rule out outliers or individual variables influencing data. Further investigation is recommended.

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Myofascial trigger points in children with tension-type headache: a new diagnostic and therapeutic option?

Cited by 4 publications

References 9 publications

Muscle trigger point therapy in tension-type headache

Muscle trigger point therapy in tension-type headache

Myofascial Head Pain

Remedial massage therapy interventions including and excluding sternocleidomastoid, scalene, temporalis and masseter muscles for Chronic Tension Type Headaches: A case series.

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