Increased Pericranial Tenderness, Decreased Pressure Pain Threshold, and Headache Clinical Parameters in Chronic Tension-type Headache Patients

Pressure pain thresholds and responses to painful mechanical stimuli were obtained from 20 subjects with episodic tension-type headaches (TTH). Tender points in the temporalis and trapezius muscles were studied, along with two nontender points, one in the temporalis and one on the Achilles tendon. Two examinations were performed, one during and one without a headache, and results were compared. No significant differences were found in either variable for any tested points. The data demonstrate that the sensitivity level of these points does not differ based on the presence or absence of TTH. This suggests that the muscle sensitivity in TTH is constant. The observation that the sensitivity levels of both tender and nontender points did not vary suggests that the underlying mechanism or effect of TTH is not restricted to tender muscles.

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Cyclic changes in sensations to painful stimuli in migraine patients

Cephalalgia ◽

10.1177/0333102418793641 ◽

2018 ◽

Vol 39 (5) ◽

pp. 585-596 ◽

Cited By ~ 2

Author(s):

Marion Strupf ◽

Britta Fraunberger ◽

Karl Messlinger ◽

Barbara Namer

Keyword(s):

Healthy Subjects ◽

Pressure Pain Threshold ◽

Episodic Migraine ◽

Tension Type Headache ◽

Prodromal Symptoms ◽

Axon Reflex ◽

Pressure Pain ◽

Chronic Tension Type Headache ◽

Type Headache ◽

Cyclic Changes

Introduction Migraine is characterized by cycling phases (interictal, preictal, ictal and postictal) with differing symptoms, while in chronic tension type headache pain phases are fluctuating. The question we asked is whether these phases are associated with changes in parameters of somatosensation and axon-reflex erythema. Methods Patients with episodic migraine and chronic tension type headache were examined psychophysically in the interictal, preictal and ictal phase and healthy subjects on five different test days. Thresholds and suprathreshold ratings of pressure and electrical pain were assessed on three different regions of the head. In migraine patients and in healthy controls, electrically induced axon-reflex erythema was measured in the area of the first trigeminal branch. All migraine patients filled out questionnaires about prodromal symptoms at every visit. Results The axon-reflex erythema was always larger in patients with migraine in contrast to healthy subjects. The pressure pain threshold was lower in migraine patients and chronic tension type headache in comparison to healthy subjects. Electrical pain thresholds did not differ between headache patients and healthy subjects and showed no changes between the phases. However, suprathreshold pain ratings showed less habituation solely in the preictal phase of migraine. The number of prodromal symptoms in migraine patients was increased in the preictal and ictal phase. Discussion Reduced habituation was the unique sign of the preictal phase in migraine patients, independently of prodromal symptoms, whereas a larger axon-reflex erythema and higher pressure pain sensitivity are constitutional and non-phase dependent properties of migraine. Reduced inhibitory mechanisms in the preictal phase may contribute to trigger headache attacks in migraine.

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MUSCULAR PRESSURE PAIN THRESHOLD AND INFLUENCE OF CRANIOCERVICAL POSTURE IN INDIVIDUALS WITH EPISODIC TENSION-TYPE HEADACHE

Coluna/Columna ◽

10.1590/s1808-185120171602162637 ◽

2017 ◽

Vol 16 (2) ◽

pp. 137-140 ◽

Cited By ~ 1

Author(s):

Ana Elisa Zuliani Stroppa-Marques ◽

João Simão de Melo-Neto ◽

Sâmela Parente do Valle ◽

Cristiane Rodrigues Pedroni

Keyword(s):

Pain Threshold ◽

Randomized Study ◽

Pressure Pain Threshold ◽

Tension Type Headache ◽

Control Group ◽

Lower Sensitivity ◽

Cross Sectional ◽

Pressure Pain ◽

Upper Trapezius ◽

Type Headache

ABSTRACT Objective: The objective of this study was to analyze the pressure pain threshold (PPT) of the sternocleidomastoid (SCM), suboccipital (SO) and upper trapezius (UT) muscles and the craniocervical posture in individuals with episodic tension-type headache (ETTH). Methods: This study was a cross-sectional, non-randomized study with 60 young adults (77% female) comprising both sexes and an age range of 18-27 years. Individuals were distributed into a control group (G1) and individuals with ETTH (G2). The frequency of headaches per month was recorded. A pressure dynamometer was used to evaluate the PPT. Photogrammetry was used to evaluate the cervical lordosis (CL) and cephalic protrusion (CP). The data were statistically analyzed. Results: There were differences in the PPT, where the UT, SO and SCM muscles presented lower sensitivity to pain, respectively. The SCM muscle presented a lower PPT in G2. The CL and CP angles were significantly lower in G2. Conclusion: Individuals with ETTH exhibited a significantly lower PPT in the SCM and SO muscles than in the UT muscle. Nevertheless, individuals with ETTH presented with the SCM muscle being more sensitive to pain as well as higher CL and CP than individuals without symptomatology.

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Increased Prevalence of Tension-Type Headache Over a 12-Year Period is Related to Increased Pain Sensitivity. A Population Study

Cephalalgia ◽

10.1111/j.1468-2982.2006.01248.x ◽

2007 ◽

Vol 27 (2) ◽

pp. 145-152 ◽

Cited By ~ 36

Author(s):

L Buchgreitz ◽

AC Lyngberg ◽

L Bendtsen ◽

R Jensen

Keyword(s):

Population Study ◽

Central Sensitization ◽

Pain Sensitivity ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Tension Type Headache ◽

Danish Population ◽

Cross Sectional ◽

Pressure Pain ◽

Type Headache

We recently reported an increase in prevalence and frequency of tension-type headache (TTH) over a 12-year period in the young Danish population. The aim of the present study was to analyse whether this increase was related to increased pain sensitivity. The study was a cross-sectional replicate of a large Danish population study. It compared 113 subjects aged 25-36 years in 2001, with 221 comparable subjects in 1989. Tenderness was considerably higher in 2001 than in 1989. When stratified according to presence of headache, the increase in tenderness was clinically and statistically significant only in women with frequent TTH. The pressure pain threshold was significantly lower in 2001 compared with 1989 in women with frequent TTH. The increase in tenderness in the population may predict an even higher prevalence of TTH in future. The changes support the hypothesis of central sensitization in TTH.

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Use of pressure dynamometer in the assessment of the pressure pain threshold in trigger points in the craniocervical muscles in women with unilateral migraine and tension-type headache: An observational study

International Journal of Osteopathic Medicine ◽

10.1016/j.ijosm.2017.03.003 ◽

2017 ◽

Vol 26 ◽

pp. 28-35 ◽

Cited By ~ 1

Author(s):

Rita de Cássia Correia Kälberer Pires ◽

Natália Salles da Rocha ◽

Jorge E. Esteves ◽

Márcia Elisabeth Rodrigues

Keyword(s):

Observational Study ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Trigger Points ◽

Tension Type Headache ◽

Pressure Pain ◽

Type Headache

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Musculoskeletal physical outcome measures in individuals with tension-type headache: A scoping review

Cephalalgia ◽

10.1177/0333102413492913 ◽

2013 ◽

Vol 33 (16) ◽

pp. 1319-1336 ◽

Cited By ~ 33

Author(s):

Jacques Abboud ◽

Andrée-Anne Marchand ◽

Karin Sorra ◽

Martin Descarreaux

Keyword(s):

Pain Threshold ◽

Pressure Pain Threshold ◽

Trigger Points ◽

Tension Type Headache ◽

Forward Head Posture ◽

Pressure Pain ◽

Head Posture ◽

Headache Pain ◽

Physiological Outcomes ◽

Type Headache

Introduction Individuals with tension-type headache (TTH), in addition to headache pain, typically suffer from pericranial muscle tenderness and increased cervical muscle tone. Physical and physiological outcomes related to musculoskeletal function, however, are not commonly assessed in clinical studies and not systematically proposed as outcome measures in headache-related practice guidelines. Objectives To review which musculoskeletal outcomes are used in the clinical assessment of patients with TTH and which are associated with headache pain and related dysfunction. Methods: Literature searches were performed in MEDLINE, PubMed, the Cochrane databases and EMBASE using terms relating to musculoskeletal physical outcomes in TTH. Results Twenty-six studies met selection criteria. Physiological outcomes typically reported in laboratory studies were trigger points, pressure pain threshold, range of motion and tenderness. A greater number of trigger points and lower pressure pain threshold were reported in patients with episodic TTH in comparison with healthy subjects. Individuals with chronic TTH, when compared with non-headache controls, consistently showed a greater number of trigger points, a lower value of pressure pain threshold and a more severe forward head posture. Conclusion Musculoskeletal outcomes, such as trigger points, pressure pain threshold and forward head posture should inform TTH pathophysiology, diagnosis and interdisciplinary patient care.

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