Relationship of active trigger points with related disability and anxiety in people with tension-type headache

Abstract

To investigate the differences in the presence of trigger points (TrPs) and their association with headache-related disability and mood disorders in people with frequent episodic tension-type headache (TTH) (FETTH) and chronic TTH (CTTH). One hundred twenty-two individuals with TTH participated. Clinical features of headache (i.e., intensity, duration, and frequency) were recorded on a headache diary. Headache-related disability was assessed with the Headache Disability Inventory, trait and state anxiety levels with State-Trait Anxiety Inventory, and depression with the Hospital Anxiety and Depression Scale. TrPs were bilaterally explored in the temporalis, masseter, suboccipital, upper trapezius, splenius capitis, and sternocleidomastoid muscles. Sixty-two (51%) patients were classified as FETTH, whereas 60 (49%) were classified as CTTH. Individuals with CTTH showed higher burden of headache and depression than FETTH (P < 0.001). Subjects with FETTH showed similar number of TrPs (total number: 5.9 ± 3.1, active TrPs: 4.7 ± 2.5, and latent TrPs: 1.2 ± 1.9) than those with CTTH (total number: 5.7 ± 3.2, active TrPs: 4.2 ± 3.0, and latent TrPs: 1.5 ± 1.8). The number of active TrPs was significantly associated with the burden of headache (r = 0.189; P = 0.037) and trait anxiety (r = 0.273; P = 0.005): the higher the number of active TrPs, the greater the physical burden of headache or the more the trait anxiety level. No association with the depression was observed. The presence of active TrPs in head and neck/shoulder muscles was similar between individuals with FETTH and CTTH and associated with the physical burden of headache and trait anxiety levels independently of the subgroup of TTH.

Active Trigger Points Are Associated With Anxiety and Widespread Pressure Pain Sensitivity in Women, but not Men, With Tension Type Headache

“…This pain model has been partially confirmed by a recent study reporting that a greater number of TrPs in head, neck, and shoulder muscles were associated with widespread pressure pain hypersensitivity in individuals with TTH . In addition, the number of active TrPs also has been associated with trait anxiety levels, another factor contributing to central sensitization by reducing the thresholds to noxious input from pericranial muscles …”

“…There is consistent evidence supporting the idea that pain referral elicited by active TrPs reproduces headache features in people with TTH; however, no previous study has investigated if the presence of TrPs is different by gender. The current study is the first one reporting gender differences in the presence of TrPs and its associations in individuals with TTH.…”

Chronic Daily Headache Disorders and Their Management : A Study

“…Often patients describe their pain as like wearing a tight band or a tight hat around the head. Presence of nausea and vomiting is considered to rule out the diagnosis of TTH (22) . Treatment For patients with frequent episodic TTH, simple analgesics and NSAIDSs, such as Aspirin and acetaminophen, are the primary option for acute therapy.…”

Frequent Episodic Tension-Type Headache in Studentes of Physiotherapy Course

“…Each of the respondents received a copy of the document, while the other remained with the researcher. The project was sent to the Research Ethics Committee of the University Center of Triângulo-UNITRI, and was approved under protocol 1,198,173.…”

“…Headaches are considered the main reason for medical consultations, either in primary care units or in neurological clinics (1,2) . Frequent episodic tension-type headache is described as frequent episodes of pain, located on both sides of the head, such as a feeling of pressure or tightness, the intensity of the pain may be mild to moderate and it may last from 30 minutes to seven days.…”