The relationship between myofascial trigger points sensitivity, cervical postural abnormality, and clinical tension-type headache parameters

ABSTRACT

Background

Myofascial Trigger Points (MTrPs) play a significant role in the pathogenesis of Tension Type Headache (TTH). Abnormal cranio-cervical posture has been linked to various types of headaches. However, the correlation between MTrPs sensitivity, cervical postural alignment, and clinical measures of headache has not been extensively studied in patients with TTH.

Objectives

To investigate the relationship between MTrPs sensitivity in cervical and pericranial muscles, cervical postural abnormality, and clinical headache parameters in patients with TTH. Furthermore, to investigate the effect of sex on the examined variables and their association with headache type (episodic vs chronic TTH).

Methods

A total of 72 patients with TTH of both sexes were enrolled in this study. Headache frequency and disability as clinical measures of headache, pressure pain threshold (PPT) of bilateral upper trapezius (UT) and suboccipital (SUB) muscles, cervical lordosis angle (CA), and anterior head translation (AHT) were measured.

Results

Pericranial MTrPs sensitivity did not demonstrate any correlation with clinical headache parameters or cervical postural abnormality. However, there was a significant correlation between the frequency of headaches and the level of disability (r = 0.32, P < 0.05). In addition, episodic TTH was more prevalent in females who exhibited greater AHT and MTrPs sensitivity of both bilateral UT and right SUB muscles than males.

Conclusions

There was no correlation found between the frequency of headaches and the level of disability with measures of cervical posture alignment or MTrPs sensitivity in individuals with TTH.. Based on findings, Clinicians should consider sex differences when assessing patients with TTH.

KEYWORDS:

• Tension-type headache
• myofascial trigger points
• cervical alignment
• forward head posture
• headache parameters

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Eman Embaby

Dr. Eman Embaby PhD, PT is an associate professor of Physical Therapy at Cairo University. Her research interest includes posture correction, electro-physical agents and psychometric properties of measurements. Her recent work investigated sex-difference in sagittal trunk kinematics and lumbar proprioception in patellofemoral pain syndrome.

Aya A Khalil

Dr. Aya A Khalil PhD, PT is a lecturer at Biomechanics Department, Faculty of Physical Therapy, Cairo University, Egypt. She was the author of many published articles in physical therapy and public health. She also has experience in professional sports and Occupational Health Physiotherapy. Her passions include refining and improving the patient examination process and validating tools used in day-to-day physical therapist practice. Her research interests are in cross-culture adaptation and validation of outcome measures in Arabic-speaking population, Virtual reality rehabilitation, posture and sport biomechanics, gait analysis and work-related musculoskeletal disorders. Her recent work was about integrating a novel Virtual Reality technology in patient rehabilitation. She shares in/ collaborates on international research projects in all physical therapy research fields.

Abdallah Mansour

Abdallah Mansour is an internship candidate, Cairo University Hospitals. His research interests are in Neuroscience, headaches, AI Machine learning for medical purposes, and rehabilitation technologies.

Hend A Hamdy

Dr. Hend A Hamdy PhD, PT is lecturer at the Department of Basic Science, Faculty of Physical Therapy, Cairo University. Her research interests are in the manual therapy and management of spine musculoskeletal disorders.