Article

Referred pain areas of active myofascial trigger points in head, neck, and shoulder muscles, in chronic tension type headache.

Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Journal of bodywork and movement therapies 10/2010; 14(4):391-6. DOI: 10.1016/j.jbmt.2009.06.008
Source: PubMed

ABSTRACT SUMMARY: Our aim was to analyze the differences in the referred pain patterns and size of the areas of those myofascial trigger points (TrPs) involved in chronic tension type headache (CTTH) including a number of muscles not investigated in previous studies. Thirteen right handed women with CTTH (mean age: 38 ± 6 years) were included. TrPs were bilaterally searched in upper trapezius, sternocleidomastoid, splenius capitis, masseter, levator scapulae, superior oblique (extra-ocular), and suboccipital muscles. TrPs were considered active when both local and referred pain evoked by manual palpation reproduced total or partial pattern similar to a headache attack. The size of the referred pain area of TrPs of each muscle was calculated. The mean number of active TrPs within each CTTH patient was 7 (95% CI 6.2-8.0). A greater number (T = 2.79; p = 0.016) of active TrPs was found at the right side (4.2 ± 1.5) when compared to the left side (2.9 ± 1.0). TrPs in the suboccipital muscles were most prevalent (n = 12; 92%), followed by the superior oblique muscle (n =11/n = 9 right/left side), the upper trapezius muscle (n = 11/n = 6) and the masseter muscle (n = 9/n=7). The ANOVA showed significant differences in the size of the referred pain area between muscles (F = 4.7, p = 0.001), but not between sides (F = 1.1; p = 0.3): as determined by a Bonferroni post hoc analysis the referred pain area elicited by levator scapulae TrPs was significantly greater than the area from the sternocleidomastoid (p = 0.02), masseter (p = 0.003) and superior oblique (p = 0.001) muscles. Multiple active TrPs exist in head, neck and shoulder muscles in women with CTTH. The referred pain areas of TrPs located in neck muscles were larger than the referred pain areas of head muscles. Spatial summation of nociceptive inputs from multiple active TrPs may contribute to clinical manifestations of CTTH.

0 Bookmarks
 · 
125 Views
  • Source
    Journal of Musculoskeletal Pain 06/2013; 21(2):183. · 0.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Dry needling is a therapeutic intervention that has been growing in popularity. It is primarily used with patients that have pain of myofascial origin. This review provides background about dry needling, myofascial pain, and craniofacial pain. We summarize the evidence regarding the effectiveness of dry needling. For patients with upper quarter myofascial pain, a 2013 systematic review and meta-analysis of 12 randomized controlled studies reported that dry needling is effective in reducing pain (especially immediately after treatment) in patients with upper quarter pain. There have been fewer studies of patients with craniofacial pain and myofascial pain in other regions, but most of these studies report findings to suggest the dry needling may be helpful in reducing pain and improving other pain related variables such as the pain pressure threshold. More rigorous randomized controlled trials are clearly needed to more fully elucidate the effectiveness of dry needling.
    Current Pain and Headache Reports 08/2014; 18(8):437. · 1.67 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In this edition of the myofascial literature review column, we included a large number of clinical studies. Of particular interest are the studies by Mayoral et al. who introduced a smart way to conduct true double blind studies of trigger point [TrP] dry needling and an important study from Norway, which addresses the presence and management of TrPs in patients with lower limb amputations. Several prevalence papers were published about TrPs in the shoulder with impingement syndrome and the hip with patellofemoral pain [PFP]. From the National Institutes of Health and George Mason University comes the next paper on characterizing TrPs using sonography. We conclude the review with several interesting case reports. Observant readers will note that we no longer indicate which author prepared which review as all reviews are the results of collaboration between the two authors.
    Journal of Musculoskeletal Pain 08/2013; 3(21):281. · 0.33 Impact Factor

Full-text (3 Sources)

Download
24 Downloads
Available from
Nov 19, 2014