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[Tension type headache with special reference to muscle abnormality]

M Sakuta1

  • 1Department Neurology, Japanese Red Cross Medical Center.

Rinsho Shinkeigaku = Clinical Neurology
|December 1, 1995
PubMed
Summary

Muscle contraction headache (MCH) originates from posterior neck muscle strain, causing referred pain. Local anesthesia of occipital tender points effectively alleviates MCH pain.

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Area of Science:

  • Neurology
  • Pain Medicine
  • Musculoskeletal Disorders

Context:

  • Muscle contraction headache (MCH), a subtype of tension-type headache, is often triggered by prolonged neck flexion.
  • EMG activity in posterior neck muscles is elevated in MCH patients compared to controls, especially with downward head posture.
  • Reduced posterior neck muscle blood flow during sustained downward head positions is observed in MCH patients.

Purpose:

  • To investigate the pathophysiology of muscle contraction headache (MCH).
  • To identify the source of pain in MCH.
  • To explore factors contributing to MCH susceptibility and exacerbation.

Summary:

  • MCH involves increased EMG activity and decreased blood flow in posterior neck muscles during specific head postures.
  • Headache onset correlates with sustained neck flexion and is relieved by upward head movement.
  • Local anesthesia applied to occipital tender points, identified as the insertion points of occipital neck muscles, completely resolves MCH pain, indicating it's a referred pain phenomenon.

Impact:

  • This research clarifies MCH as referred pain originating from occipital tender points.
  • Identifies patient subgroups susceptible to MCH, including those with cervical instability or heavy head weight.
  • Highlights psychological stress, hypotension, anemia, and muscle weakness as contributing factors to MCH.

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