Turkish Journal of Physical Medicine and Rehabilitation 2010 , Vol 56 , Num 1
Myofascial Pain Syndrome in Chronic Tension-Type Headache
Burcu Duyur Çakıt 1 ,Hatice Rana Erten 2 ,Esin Çetinkaya 3 ,Barış Nacır 4 ,Meryem Saraçoğlu 5
1 Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi, 2. Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara
2 Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiy
3 Sağlık Bakanlığı Fatsa Devlet Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, Ordu, Türkiye
4 Ankara Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye
5 2nd Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey

Objective: The aim of this study was to investigate the presence of active and latent trigger points and to determine their relationship to pain-pressure thresholds of cervical muscles, neck mobility, head position and depression in patients with tension-type headache (TTH).
 

Materials and Methods: Twenty-seven patients with TTH and 19 healthy subjects without history of headache were included. The presence of active and latent trigger points in the sternocleidomastoid, trapezius, levator scapulae, multifidus, and suboccipital muscles were investigated. Pain-pressure thresholds were measured in the sternocleidomastoid, trapezius, levator scapulae, multifidus, and suboccipital muscles of both sides. Cervical range of motion of the patients and control subjects were measured using a goniometer. Measurements of cranio-vertebral angle were performed in the patients and control subjects. Psychological status of both groups was determined using Beck Depression Inventory. 
 

Results: Twenty-one patients had active trigger points in at least one of the analyzed muscles. Five patients had no active trigger point in any muscle, but the occurrence of latent trigger points was detected in these patients. One patient had no active or latent trigger point. Within the control subjects, there was no active trigger point, but 12 subjects had latent trigger points in at least one of the analyzed muscles. Neck mobility of the patients was more restricted compared to the control subjects. Pain-pressure threshold values of the patients were lower than those of the control subjects (p<0.05). Craniovertebral angle values obtained from both sitting and standing positions were significantly lower in the patients than in the controls (p<0.05). Within the patient group, the mean Beck Depression Inventory Scores were higher than that in the control subjects (p=0.0001).
 

Conclusion: The results of the present study indicate that, almost all TTH patients had trigger points, altered craniovertebral posture and restricted neck mobility. Therefore, it is thought that, cervical myofascial pain syndrome may play an important role in both pathogenesis and exacerbation of the symptoms of TTH.

Keywords : Tension-type headache, cervical myofascial pain syndrome, craniovertebral angle