Relationship between Headache and Myofascial Pain: Systematic Review

Aims: To systematically investigate the relationship between headache and myofascial. Study design: Systematic Review. Place and Duration of Study: Department of Oral and Maxillofacial surgery, Riyadh Elm University, Riyadh, Saudi Arabia. Between June 2020 and November 2021. Methodology: A systematic search of the literature was conducted between 2006 and 2019 in seven electronic databases (Brain, Pub Med, ScienceDirect database, NCBI, Web of Science Core Collection, Google Scholar, Scopus, and Saudi digital library). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed and the clinical question in PICO format was the relationship between headache and myofascial pain. The initial search resulted in 663 articles. Only 9 studies were selected for qualitative synthesis after fulfilling the eligibility criteria (three double blind Randomized Controlled Trials RCTs and one retrospective cohort study). The results showed that there is a consistent trend in the literature supporting the relationship between headache and MFP. Results: The first search showed 663 articles. A total of 110 duplicates were eliminated. After filtering by reading titles and abstracts and discarding any extraneous topics or goals that are not directly connected to this systematic review, the first phase comprised 49 publications. There were 14 papers that needed to be reviewed and evaluated for eligibility. Nine articles were chosen for the final evaluation after full text screening. Conclusion: The findings point to a significant association between headache disability and musculoskeletal disorders of the head and neck. The absence of an agreement in Orofacial Pain research methodology, unified approaches, has an impact on the optimal collecting requirements for a systematic review.

Validity and Reliability of Persian Version of Henry Ford Hospital Headache Disability Inventory Questionnaire

Background: A limited number of headache disability indices exist that can evaluate and manage different disabilities related to headache among Iranian patients. Objective: This study aimed to translate and validate the Persian version of the Henry Ford headache disability inventory (HDI). Methods: The original questionnaire was translated and culturally adapted to the Persian setting. A total of 250 patients with chronic headache were enrolled in this study. The questionnaire’s face validity, content validity, and convergent validity with Short-Form Health Survey (SF-36) were evaluated and a confirmatory factor analysis (CFA) was conducted. Its internal consistency was also assessed and its short- and long-term test-retest reliability were examined by intraclass correlation coefficient (ICC). Results: The content validity indices were 0.85, 0.99, and 0.97 for simplicity, relevance, and clarity, respectively. The content validity ratio was calculated as one for all items. The findings of CFA confirmed that this index had a good fit. Cronbach’s alpha was 0.91, 0.82, and 0.86 for the entire questionnaire as well as its functional and emotional subscales, respectively. The ICC was also calculated as 0.97 for the total inventory. The convergent validity showed significant negative correlations between HDI and short-form health survey items. Conclusion: The validity and reliability of the Persian version of the HDI were confirmed. This questionnaire can explore the disabilities of Persian-speaking people with headache disorders.

The The Effects of Massage Therapy on a Patient with Migraines and Cervical Spondylosis: a Case Report

Background: Migraines involve moderate- to-severe neck and face pain that lasts four to 72 hours, and are followed by fatigue and stiffness. Migraines are treated using medications, massage therapy (MT), and non-pharmacological alternatives. Cervical spondylosis (CS) is characterized by degeneration of the intervertebral discs, neck pain, and involvement of soft tissues in the cervical area. CS is treated using medications and manual therapy, including MT. Objective: To determine the effects of MT on cervical range of motion and daily function in a patient with migraines and CS. Case Presentation: The patient was an active 56-year-old female diagnosed with migraines and CS. Initial evaluation included cervical range of motion (ROM), goniometry, reflexes, myotomes, dermatomes, local sensation testing and orthopedic tests. Assessment was followed by five MT treatments. Swedish massage, myofascial trigger point release, and proprioceptive neuromuscular facilitation (PNF) stretching were applied to the back, neck, head, and face. The Headache Disability Index (HDI) was administered on the initial and final visits to evaluate patient function. Cervical ROM was measured pre- and posttreatment using a universal goniometer. Treatment was conducted by a second-year MT student at the MacEwan Massage Therapy Teaching Clinic in Edmonton, Alberta. Results: All cervical ranges of motion improved. The Headache Disability Index score decreased, but was not considered significant. The patient reported decreased stiffness in the upper back and shoulders, reduced migraines, and better sleeping patterns after the MT intervention. Conclusion: MT was effective in increasing cervical ROM, but had no significant effect on daily function. Further research is warranted on effects of MT on CS and migraines.

CORTICAL INTEGRATIVE THERAPY FOR THE TREATMENT OF MIGRAINES AND HEADACHES

Migraine is a common neurological disorder that is characterized by a host of symptoms including severe throbbing headaches. In this retrospective chart review, the effectiveness of Cortical Integrative Therapy (PedroCIT®) was examined in adults with migraines. Multivariate General Linear Model (M-GLM) was utilized to determine if the emotional, functional, and overall difficulties, as well as the intensity of pain experienced with headaches decreased from before to after PedroCIT® treatment in individuals with mild to complete disability resulting from headaches. Repeated Measures General Linear Model (RM-GLM) was also used to investigate if postural stability increased from pre- to post-treatment. The results of the M-GLM showed that PedroCIT® was effective in reducing emotional, functional, overall disability, and intensity of pain resulting from headaches. Furthermore, RM-GLM indicated that patients who underwent PedroCIT® improved their postural stability from pre- to post-treatment. Finally, the findings also showed that the duration of the treatment did not have any effect among patients with varied degrees of headache disability. This study illustrates the effectiveness of PedroCIT® in the treatment of headaches and postural instability in migraine patients.

Effect of High-Velocity Low-Amplitude Thrust Manipulation of Upper Cervical Spine on Pulmonary Function Test and Headache Disability Index in Patients with Migraine Headache

Introduction. Migraine is a common debilitating disorder of neurovascular origin which affects younger adults, especially women. Material and Methods. It was an experimental study design. A convenience type of sampling was used for recruitment of the subjects. A total of 21 participants diagnosed with migraine (6 males and 15 females) fulfilling the inclusion criteria were taken for this study and assigned to one of the two groups (experimental or control group). PFT measured with PFT apparatus (Spirolab 111, Serial No. A23-053 13974) and HDI score were calculated before the start of the intervention and after the intervention. Afterwards, PFT was performed by each participant followed by HVLA thrust manipulations to the migraine patients and an equal period of rest to the control group. Results. There are no significant differences between baseline and post-intervention outcome variables and in mean changes between the two groups. One-way ANOVA was used to analyze the change in HDI score which was calculated three times (pre- prior to intervention, post- after the intervention and 1 month after the intervention). The experimental group showed a significant reduction in the score after the manipulation. It was found that FVC and PEF were positively correlated to FEV1, and FVC was also positively correlated to PEF. Conclusions. The findings of the study revealed that high-velocity thrust manipulations of upper cervical spine were not effective in improving pulmonary functions of migraine patients although it was found effective in improving subjective symptoms of the patients evaluated through HDI.

Response to Mindfulness-Based Cognitive Therapy Differs Between Chronic and Episodic Migraine

Objective:Evaluate whether the benefits of Mindfulness-Based Cognitive Therapy for Migraine (MBCT-M) on headache disability differs among people with episodic and chronic migraine.Methods:This is a planned secondary analysis of a randomized clinical trial. After a 30-day baseline, participants were stratified by episodic (6-14 days/month) and chronic migraine (15-30 days/month) and randomized to 8 weekly individual sessions of MBCT-M or wait list/treatment as usual (WL/TAU). Primary outcomes [Headache Disability Inventory; Severe Migraine Disability Assessment Scale (scores ≥ 21)] were assessed at Months 0, 1, 2, and 4. Mixed models for repeated measures tested moderation with fixed effects of treatment, time, chronic migraine and all interactions. Planned subgroup analyses evaluated treatment*time in episodic and chronic migraine.Results:Of 60 participants (MBCT-M N = 31, WL/TAU N = 29), 52% had CM. CM moderated the effect of MBCT-M on Severe Migraine Disability Assessment Scale, F(3, 205) = 3.68, p = .013; MBCT-M vs. WL/TAU reduced the proportion of people reporting severe disability to a greater extent among people with EM (-40.0% vs. -14.3%) than CM (-16.4% vs. +8.7%). Subgroup analysis revealed MBCT-M (vs WL/TAU) significantly reduced Headache Disability Inventory for episodic (p = .011) but not chronic migraine (p = .268).Conclusions:MBCT-M is a promising treatment for reducing headache-related disability, with greater benefits in episodic than chronic migraine.Classification of EvidenceThis study provides Class III evidence that MBCT-M reduces headache disability to a greater extent in people with episodic than chronic migraine. NCT02443519.

Brazilian Portuguese version of the Headache Disability Inventory: Cross-cultural adaptation, validity, and reliability

Background The Headache Disability Inventory assesses the dimensions of headache disability, but it is not available in Brazilian Portuguese yet. We aimed to translate the Headache Disability Inventory into Brazilian Portuguese and analyze its measurement properties. Methods Consecutive patients with headaches diagnosed by expert neurologists as per the International Classification of Headache Disorders were included. For the cross-cultural adaptation, 30 individuals answered the translated Headache Disability Inventory version. The internal consistency was evaluated, and the structural validity was assessed through exploratory factor analysis. For the construct validity assessment, 132 individuals answered the Headache Disability Inventory-Brazil, 12-item Short Form Survey (SF-12), and Headache Impact Test (HIT-6). After 1–3 weeks, 67 individuals again answered the Headache Disability Inventory-Brazil for the reliability assessment. The Pearson's correlation test, the intraclass correlation coefficient and the standard error of measurement were analyzed. Results The pre-stage version of the questionnaire was considered as the final version. The Headache Disability Inventory-Brazil had an internal consistency of 0.84 and consisted of a functional, emotional and social participation domain (factor loads > 0.3). The internal consistency ranged from 0.81 to 0.93 for each of the three domains. For the construct validity, the Headache Disability Inventory-Brazil presented moderate correlation with the SF-12 (r = −0.70, p < 0.05) and with the HIT-6 (r = 0.67, p ≤ 0.05). Its test-retest reliability was considered to be excellent (intraclass correlation coefficient = 0.95) and the standard error of measurement was 2.26 points. Conclusion The Headache Disability Inventory-Brazil was successfully translated and culturally adapted to the Brazilian population. It can be used for the impact assessment of primary and secondary headaches with validity and reliability equivalent to its original version.

Effects of Cinnamon on Anthropometry Status and Headache Disability of Migraine Patients: A Randomized Double-blind Placebo-controlled Trial

Background: Migraine is a common type of primary headache that is highly disabling and is possibly associated with obesity. Increasing body mass index (BMI) seems to be a risk factor for migraine attacks. Cinnamon has anti-inflammatory, neuroprotective, and anti-obesity effects. Thus, this study aimed to assess the effects of cinnamon on anthropometry status and headache disability of migraine patients.Methods: Fifty patients with migraine were randomized to receive either cinnamon powder, three capsules/day each containing 600 mg of cinnamon or three placebo capsules/day each containing 100 mg of corn starch (control group) for two months. Height, body weight (BW), waist circumference (WC), and hip circumference (HC) were measured at baseline and the end of the study. Furthermore, Minimal or Infrequent Disability (MIDAS) and Headache Daily Result (HDR) Questionnaire were recorded. Results: After follow-up, BW and BMI did not change in the intervention group, however, both of them significantly increased in the placebo group. The differences between the two groups were statistically significant (p=0.001). WC significantly decreased in the cinnamon group and remarkably increased in the control group; the difference between groups was significant (p<0.001). Furthermore, HC and WHR significantly decreased in the intervention group than the placebo group (p=0.001). HDR and the total score of disability in migraine patients were significantly decreased in the intervention versus the control group (p<0.001). Conclusion: Cinnamon seems to have beneficial effects on BW, BMI, WC, and HC and it reduces the headache disability of migraine patients. More randomized controlled trials should be undertaken to confirm these effects.