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Related Experiment Video

Updated: Jun 10, 2026

Measurement & Analysis of the Temporal Discrimination Threshold Applied to Cervical Dystonia
10:05

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Published on: January 27, 2018

Cervical musculoskeletal function is variable in tension-type headache: A cluster analysis.

Chalomjai Pensri1, Zhiqi Liang1, Julia Treleaven1

  • 1School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia.

Headache
|June 8, 2026
PubMed
Summary
This summary is machine-generated.

Neck pain in tension-type headache (TTH) can stem from cervical musculoskeletal dysfunction in about 30% of cases. However, over 70% of TTH patients with neck pain show normal cervical function, suggesting pain is linked to headache pathophysiology.

Keywords:
active trigger pointscervical musculoskeletal impairmentsneck painpain sensitivitytendernesstension‐type headache

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Area of Science:

  • Musculoskeletal disorders
  • Neurology
  • Pain management

Background:

  • Neck pain is a frequent complaint in tension-type headache (TTH), but its origins remain unclear.
  • Individuals with TTH often exhibit heightened pain sensitivity, tenderness, and active trigger points.
  • Understanding the intricate mechanisms of neck pain in TTH is crucial for effective patient management.

Purpose of the Study:

  • To investigate the causes of neck pain in TTH by examining how patients with TTH, idiopathic neck pain (INP), and healthy controls group based on cervical musculoskeletal dysfunction.
  • To identify differences in TTH features, pain sensitivity, tenderness, and active trigger points among identified clusters.

Main Methods:

  • A cross-sectional study involving 80 TTH patients, 25 INP patients, and 27 healthy controls.
  • Comprehensive musculoskeletal assessments of the cervical spine, including kinematics, joint dysfunction, muscle function, and joint position sense.
  • Evaluations of pain sensitivity (pressure pain thresholds, cold pain thresholds, wind-up ratio), pericranial tenderness, and active trigger points, followed by cluster analysis.

Main Results:

  • Two clusters emerged: Cluster 1 (n=85) with normal cervical function (primarily healthy controls) and Cluster 2 (n=47) with cervical musculoskeletal disorder (primarily INP patients).
  • Of TTH patients, 71.2% were in Cluster 1, with most reporting neck pain, while 28.8% were in Cluster 2, reporting higher neck pain intensity and decreased pressure pain thresholds.
  • No significant differences in tenderness or active trigger points were found between TTH clusters.

Conclusions:

  • Approximately 30% of TTH patients exhibit cervical musculoskeletal disorders, suggesting a potential peripheral source for neck pain.
  • Over 70% of TTH patients with neck pain clustered with healthy controls, indicating the pain is likely linked to headache pathophysiology.
  • Pain sensitivity, tenderness, and trigger points in TTH appear driven by headache mechanisms rather than cervical musculoskeletal disorders, necessitating individualized treatment approaches for neck pain in TTH.