Neck Musculature and EMG Biofeedback in Treatment of Muscle Contraction Headache

Abstract

SYNOPSIS Muscle contraction headache is believed to result from sustained contraction of muscles involving the neck, scalp, and frontalis musculature. This study stresses the clinical importance of examining neck muscle activity in 16 subjects. Two questions are addressed: (1) Do subjects who in the process of treatment for headaches originating from the neck and who received EMG feedback from frontalis and neck musculature select the neck feedback site as more useful in the control of headache? (2) Is frontalis activity as measured by the EMG a measure of the level of activity in other portions of the skeletal system, namely neck musculature? Results indicate that neck involvement varies significantly among patients complaining of chronic muscle contraction headaches, and that a substantial number of subjects experience far more neck than frontalis activity and benefit from behavioral techniques applied to that area. Our findings indicate that attending specifically to neck tissue is a useful therapeutic goal. Consequently, post‐treatment results show significant reductions in neck tissue muscle activity, especially for patients reporting significant neck symptomatology and/or those with high levels of EMG neck activity who reported that behavioral techniques applied to the neck area were helpful for controlling the muscle activity related to their headaches.

A Comparison of Frontal Electromyographic Biofeedback Training, Trapezius Electromyographic Biofeedback Training, and Progressive Muscle Relaxation Therapy in the Treatment of Tension Headache

“…Two other studies have employed, but were unable to compare, frontal and neck biofeedback for reduction of tension headache activity. 15,16 In these studies, the biofeedback alternated between the frontal and back of the neck region within the same subject. Both studies found significant reductions in the headache activity of most subjects; however, as the treatments were alternated within the same subjects, as opposed to between two different groups of subjects, it is diffficult to draw any useful conclusions.…”

Significance of EMG Surface Electrode Placement Models and Headache Findings

“…Muscle tightness recorded in other regions of the face, neck or shoulders may be responsible for head pain and may not correlate with frontalis tension. 6 More and more clinicians are asking whether muscle contraction headache should be measured and treated from frontalis muscle sites. Authors in five biofeedback studies reported significant positive correlations between headache parameters and frontalis electromyogram (EMG) levels.…”

Non Drug Treatment for Migraine Headache With Associated Raynaud's Disease

“…The two main types of BFB used in clinical medicine are muscular tension control by EMG-BFB training, and vascular tone control by thermaI-BFB training. 1,2,3,4,5 Several clinical research programs carried out in recent years have proven the effectiveness of cutaneous temperature control, acquired through termal-BFB training, in the therapy of vascular headaches. 6,7,8,9,10,11 By analysing the literature, acquisition of the peripheral vasodilating reaction (acquired through thermaI-BFB training) seems to be correlated with a Iowering of sympathetic arousal measured through dopamine-beta-hydroxylase levels.…”