A Structured Myofascial Pain Management Program for Chronic Headache Including Medication-Refractory Cases

Background and objective Musculoskeletal factors, such as myofascial pain, are often overlooked in chronic headaches. This study aimed to evaluate the effectiveness of a structured self-care program, myofascial pain management (MPM), for patients with chronic headaches. Methods This single-arm observational study involved 37 patients with chronic headaches who were referred from a neurology clinic. The patients were categorized into two groups: suspected myofascial pain (n=19) and medication-refractory (n=18). All patients underwent the MPM program, which included instructions for self-massage and stretching techniques. Treatment effectiveness was evaluated using the pain item in the Integrated Palliative Care Outcome Scale (IPOS), with a score of ≤1 indicating improvement. Results The overall improvement rate in the patients was 76%, with significant improvements observed in the myofascial (84%; p=0.00017) and refractory (67%; p=0.00038) groups. Of the 28 patients who demonstrated improvements, 25 (89%) achieved this outcome without changing their prescribed headache medications. Conclusions The MPM program was effective for patients with chronic headache, including those with medication-refractory headache. Evaluation of the masticatory and pericranial muscles, along with the introduction of a structured self-care program, could prove to be a valuable nonpharmacological strategy for headache management.