Pericranial muscle hardness in tension-type headache. A non-invasive measurement method and its clinical application

Using a new method to measure the hardness of pericranial muscles, the role of muscle factors in tension-type headache was evaluated. In 223 normal healthy subjects, the hardness of trapezius muscles was 82 +/- 15 kPa/cm (mean +/- SD). The muscle hardness in women, 92 +/- 17 kPa/cm, was significantly greater than that in men, 74 +/- 14 kPa/cm (P < 0.01). Trapezius muscles were significantly harder than paraspinal posterior neck muscles measured at the level of the fifth cervical vertebra (71 +/- 13 kPa/cm; n = 26) but a significant correlation in muscle hardness did exist between these two muscle groups (r = 0.89, P < 0.001). Muscle hardness did not show a significant correlation with advancing age, blood pressure or subjective feeling of stiffness in the shoulder. A significant correlation was noted between the muscle hardness measured by the present method and the stiffness scores evaluated by manual palpation. In patients with tension-type headache (n = 60), the hardness of trapezius muscles, 114 +/- 24 kPa/cm (mean +/- SD), was significantly greater than that in normal subjects (P < 0.01). Twenty-six patients (43% of the total) showed significantly high values which exceeded the mean +/- 2 SD (113 kPa/cm) of the normal value, while the remaining patients (57%) constituted a high normal group. The hardness of posterior neck muscles measured in 27 patients (99 +/- 21 kPa/cm) was also significantly greater than that in normal subjects (P < 0.01). There was no significant difference in muscle hardness between episodic tension-type headache and chronic tension-type headache.(ABSTRACT TRUNCATED AT 250 WORDS)