Trigger Points in the Suboccipital Muscles and Forward Head Posture in Tension‐Type Headache

Abstract

Suboccipital active TrPs and FHP were associated with CTTH. CCTH subjects with active TrPs reported a greater headache intensity and frequency than those with latent TrPs. The degree of FHP correlated positively with headache duration, headache frequency, and the presence of suboccipital active TrPs.

Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature

“…FHP can be linked to computer use, 28 carriage of backpacks, 29 use of smartphones, 16 headache, 30 mouth breathing, bad habit, 31 or shoulder overuse 15,23,32 (Table 1).…”

“…30 FHP has been linked to chronic tension-type, cervical, and tension type headaches. 30,33 Watson and Trott 33 reported a significantly smaller craniovertebral angle value in the headache group than in the non-headache group. Lesser craniovertebral angle meant poorer FHP.…”

“…30 Trigger points associated with taut bands of suboccipital muscles can give rise to referred pain over the occipital and temporal aspects of the head, which is perceived as headache. This headache is thought to be mediated through the spinal cord and trigeminal nucleus caudalis of the brainstem.…”

“…This means that FHP (shortened suboccipital muscles) leads to the activation of trigger points and, thus, causes tension-type headache. 30 FHP can cause accumulation of nociceptive substances in the muscles that counteracts FHP, increased compression of cervical facet joints and posterior vertebral bodies, stretching of anterior neck musculature, and shortening of posterior neck musculature. 32,34 Increased compression of the zygapophyseal joints can result in the inception of degenerative changes leading to spondylosis.…”

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

“…The whole musculoskeletal examination was independently performed by 2 trained investigators blinded for each other's examination to evaluate the interrater reliability as described by Gerwin et al 18 Regarding the suboccipital muscles, we followed the guidelines as described by Fernández-de-las-Penas et al 8 For each patient, we examined the following muscles: sternocleidomastoid, splenius capitis, upper trapezius, temporalis, semispinalis, levator scapulae, masseter, and frontalis muscles ( Table 2).…”