Myofascial trigger points, neck mobility, and forward head posture in episodic tension-type headache

Area of Science:

• Neurology
• Musculoskeletal Disorders
• Pain Management

Background:

• Tension-type headache (TTH) may involve musculoskeletal issues in the head and neck region.
• Musculoskeletal disorders are implicated in the pathogenesis of TTH.

Purpose of the Study:

• To compare trigger points, forward head posture (FHP), and neck mobility in episodic tension-type headache (ETTH) patients versus healthy controls.
• To investigate the relationship between muscle trigger points, FHP, neck mobility, and headache characteristics (intensity, frequency, duration).

Main Methods:

• A blinded, controlled pilot study involving 15 ETTH patients and 15 healthy controls.
• Identified trigger points in trapezius, sternocleidomastoid, and temporalis muscles using diagnostic criteria.
• Assessed FHP via craniovertebral angle measurement and neck mobility using a goniometer; headache parameters were tracked via diary for 4 weeks.

Main Results:

• ETTH patients exhibited significantly more active trigger points (TrPs) than controls (P < .001).
• ETTH patients demonstrated greater FHP (smaller craniovertebral angle) and reduced neck mobility compared to controls (P < .05).
• No significant correlation was found between TrP activity, FHP, neck mobility, and headache intensity, frequency, or duration within the ETTH group.

Conclusions:

• Active TrPs in specific head and neck muscles are more prevalent in ETTH subjects.
• ETTH patients commonly present with forward head posture and decreased neck mobility.
• Despite observed differences, active TrPs, FHP, and reduced neck mobility were not associated with headache severity or temporal patterns in this study.