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Rezaee H, Behkar A, Tafakhori A, Zardoui A, Farahmand G, Ranji S. Relationship of myofascial trigger points with related disability, anxiety, and depression in patients with migraine headaches. Head Face Med 2024; 20:47. [PMID: 39238006 PMCID: PMC11378560 DOI: 10.1186/s13005-024-00454-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 08/28/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Migraine affects one in ten individuals worldwide and is the second leading cause of disability. Studies have shown an association between migraine and the musculoskeletal system, and myofascial trigger points (MTrPs) play an essential role. Additionally, those with myofascial pain have been proven to experience higher levels of depression and anxiety. Understanding the association between MTrPs and migraine is crucial for developing targeted treatment strategies. Additionally, recognizing the link between MTrPs and migraine-related depression and anxiety underscores the importance of a holistic approach to migraine management. By addressing both musculoskeletal and neurological factors, healthcare providers can provide more effective and personalized care for migraine patients. This study aims to determine the association between MTrPs with migraine-related disability, anxiety, depression, and migraine characteristics. METHODS This cross-sectional study included 68 migraine patients from an outpatient neurology clinic. The number of MTrPs was determined through examination by an experienced neurologist during a migraine-free period using the recommended international criteria. We evaluated anxiety and depression with the Hospital Anxiety and Depression Scale (HADS) and disability with the Migraine Disability Assessment Scale (MIDAS). RESULTS We enrolled 68 patients (22 males) with a mean age of 36.23 ± 9.63 years. The mean number of MTrPs was 2.75 ± 2.934. MTrPs were positively correlated with severity (CC: 0.576, P-value < 0.001). There was no association between MTrPs and HADS-D or MIDAS, but migraine patients with abnormal HADS-A scores had more MTrPs than patients with normal HADS-A scores (0.6 ± 0.84 vs 3.56 ± 3.11, P-value:0.013). CONCLUSIONS The number of MTrPs is associated with higher anxiety levels and headache intensity. Further research could investigate the impact of MTrP-based therapies on anxiety among individuals suffering from migraines.
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Affiliation(s)
- Hesan Rezaee
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Behkar
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Tafakhori
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arshia Zardoui
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghasem Farahmand
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ranji
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Embaby E, Khalil AA, Mansour A, Hamdy HA. The relationship between myofascial trigger points sensitivity, cervical postural abnormality, and clinical tension-type headache parameters. J Man Manip Ther 2024; 32:390-399. [PMID: 38163855 PMCID: PMC11257008 DOI: 10.1080/10669817.2023.2299186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Myofascial Trigger Points (MTrPs) play a significant role in the pathogenesis of Tension Type Headache (TTH). Abnormal cranio-cervical posture has been linked to various types of headaches. However, the correlation between MTrPs sensitivity, cervical postural alignment, and clinical measures of headache has not been extensively studied in patients with TTH. OBJECTIVES To investigate the relationship between MTrPs sensitivity in cervical and pericranial muscles, cervical postural abnormality, and clinical headache parameters in patients with TTH. Furthermore, to investigate the effect of sex on the examined variables and their association with headache type (episodic vs chronic TTH). METHODS A total of 72 patients with TTH of both sexes were enrolled in this study. Headache frequency and disability as clinical measures of headache, pressure pain threshold (PPT) of bilateral upper trapezius (UT) and suboccipital (SUB) muscles, cervical lordosis angle (CA), and anterior head translation (AHT) were measured. RESULTS Pericranial MTrPs sensitivity did not demonstrate any correlation with clinical headache parameters or cervical postural abnormality. However, there was a significant correlation between the frequency of headaches and the level of disability (r = 0.32, P < 0.05). In addition, episodic TTH was more prevalent in females who exhibited greater AHT and MTrPs sensitivity of both bilateral UT and right SUB muscles than males. CONCLUSIONS There was no correlation found between the frequency of headaches and the level of disability with measures of cervical posture alignment or MTrPs sensitivity in individuals with TTH.. Based on findings, Clinicians should consider sex differences when assessing patients with TTH.
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Affiliation(s)
- Eman Embaby
- Basic science department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Aya A Khalil
- Biomechanics Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Abdallah Mansour
- 5 year undergraduate student, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hend A Hamdy
- Basic science department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Son JY, Goo K, Kim NY, Yang SG, Lee DH, Im YR, Kwon OB, Cho HW, Kim SD, Kim D, Ha IH. Effectiveness and Safety of Pharmacopuncture on Inpatients with Tension Headache Caused by Traffic Accidents: A Pragmatic Randomized Controlled Trial. J Clin Med 2024; 13:4457. [PMID: 39124723 PMCID: PMC11312919 DOI: 10.3390/jcm13154457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/04/2024] [Accepted: 07/18/2024] [Indexed: 08/12/2024] Open
Abstract
Background: This study investigated the effectiveness and safety of pharmacopuncture for pain relief and functional improvement in patients with traffic accident (TA)-induced acute tension headaches. Methods: The study employed a parallel, single-centered, pragmatic, randomized controlled trial design. Eighty patients complaining of acute tension headaches were randomized into the integrative Korean medicine treatment (IKM treatment) group and the pharmacopuncture group on suboccipital muscles (suboccipital muscles pharmacopuncture + IKM treatment), with 40 participants assigned to each group. The patients in the pharmacopuncture group underwent pharmacopuncture as an add-on therapy, consisting of three sessions. Both groups were reassessed 2 months post-intervention. To assess the outcomes, the Numeric Rating Scale (NRS) for Headache, NRS for Neck Pain, Headache Disability Index, Headache Impact Test-6, EuroQol 5-Dimension, and Patient Global Impression of Change were used. Results: The improvement in the outcomes of the pharmacopuncture group was significantly greater than that of the comparison group on day 4 of hospitalization in terms of pain (difference in NRS of headache -2.59, 95% CI -3.06 to -2.12; NRS of Neck pain -1.05, 95% CI -1.50 to -0.59) and function (difference in HDI -24.78, 95% CI, -31.79 to -17.76; HIT-6 -6.13, 95% CI, -9.47 to -2.78). Additionally, in 2 months of follow-up, the recovery rate of headache was significantly higher in the pharmacopuncture group than in the comparison group. Conclusions: The pharmacopuncture group demonstrated superior outcomes in symptom improvement than the comparison group did, providing insights into novel and useful applications of pharmacopuncture in the clinical practice of Korean medicine.
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Affiliation(s)
- Ja-Yean Son
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea (S.-G.Y.); (H.-W.C.); (S.D.K.)
| | - Kangmoo Goo
- Department of Korean Medicine Neuropsychiatry, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea
| | - Na-young Kim
- Department of Korean Internal Medicine, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea;
| | - Seok-Gyu Yang
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea (S.-G.Y.); (H.-W.C.); (S.D.K.)
| | - Dong Hwan Lee
- Department of Korean Acupuncture & Moxibustion Medicine, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea; (D.H.L.); (O.B.K.)
| | - Yu-Ra Im
- Department of Korean Medicine Ophthalmology & Otolaryngology & Dermatology, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea;
| | - Oh Bin Kwon
- Department of Korean Acupuncture & Moxibustion Medicine, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea; (D.H.L.); (O.B.K.)
| | - Hyun-Woo Cho
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea (S.-G.Y.); (H.-W.C.); (S.D.K.)
| | - Sang Don Kim
- Department of Korean Medicine Rehabilitation, Haeundae Jaseng Hospital of Korean Medicine, 793 Haeun-daero, Haeundae-gu, Busan 48102, Republic of Korea (S.-G.Y.); (H.-W.C.); (S.D.K.)
| | - Doori Kim
- Clinical Research Center, Jaseng Hospital of Korean Medicine, 536, Gangnam-daero, Gangnam-gu, Seoul 06110, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 2F 540 Gangnam-daero, Gangnam-gu, Seoul 06110, Republic of Korea
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Caballero Ruiz de la Hermosa C, Mesa-Jiménez JA, Justribó Manion C, Armijo-Olivo S. Are Morphometric Alterations of the Deep Neck Muscles Related to Primary Headache Disorders? A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:2334. [PMID: 36850939 PMCID: PMC9961645 DOI: 10.3390/s23042334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
This systematic review aims to summarise the evidence from studies that examined morphometric alterations of the deep neck muscles using diagnostic imaging (ultrasound imaging, magnetic resonance imaging, and computed tomography) in patients diagnosed with primary headache disorders (PHD). No previous reviews have focused on documenting morphometric changes in this population. We searched five databases (up to 12 November 2022) to identify the studies. The risk of bias (RoB) was assessed using the Quality in Prognostic Studies (QUIPS) tool and the overall quality of the evidence was assessed using The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. A total of 1246 studies were screened and five were finally included; most were at high RoB, and the overall level of confidence in results was very low. Only two studies showed a significant association between morphometric alterations of the deep neck muscles and PHD (p < 0.001); nevertheless, their RoB was high. Contradictory and mixed results were obtained. The overall evidence did not show a clear association between morphometric alterations of the deep neck muscles in patients diagnosed with PHD. However, due to the limited number of studies and low confidence in the evidence, it is necessary to carry out more studies, with higher methodological quality to better answer our question.
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Affiliation(s)
| | - Juan Andrés Mesa-Jiménez
- Department Physical Therapy, Faculty of Medicine, University of San-Pablo CEU, Campus Montepríncipe, Urb. Montepríncipe, 28925 Alcorcón, Spain
| | - Cristian Justribó Manion
- Department Physical Therapy, Faculty of Medicine, University of San-Pablo CEU, Campus Montepríncipe, Urb. Montepríncipe, 28925 Alcorcón, Spain
- Department of Transational Medicine, University of Abat Oliba CEU, CEU Universities, 08022 Barcelona, Spain
- National Centre, Foundation COME Collaboration, Via Venezia 7, 65121 Pescara, Italy
| | - Susan Armijo-Olivo
- Faculty of Business and Social Sciences, University of Applied Sciences Osnabrück, 30A, 49076 Osnabruck, Germany
- Faculties of Rehabilitation Medicine and Medicine and Dentistry, 3-48 Corbett Hall, Edmonton, AB T6G 2G4, Canada
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Clinical-Epidemiology of Tension-Type Headache among the Medical and Dental Undergraduates of King Khalid University, Abha, Saudi Arabia. J Pers Med 2022; 12:jpm12122064. [PMID: 36556284 PMCID: PMC9785983 DOI: 10.3390/jpm12122064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction (background): Headache is the primary complaint among students. Headaches mostly have multifactorial causes. The degree of headache severity significantly impacts attitudes, behavior, and academic performance. Objectives: Here, we investigate the demographic epidemiology of tension-type headaches (T.T.H.), and determine the clinical presentation and triggers of the tension-type among headache sufferers. Methods (settings, design): An institutional-based cross-sectional study (descriptive) was conducted on the medical and dental undergraduates at King Khalid University, Abha, Saudi Arabia, from 1 July 2021 to 31 December 2021. Data were gathered using a pre-designed questionnaire. A consecutive sampling method was used in a COVID-19-constrained environment. After preliminary screening of the study population, 460 samples were included. An electronic questionnaire was shared with them, and they were requested to respond. Results: More than half of the participants (258, 56.1%) experienced tension-type headaches, while the remaining 202 (43.9%) never felt a headache. Tension-type headaches manifested as heaviness of the head (44, 17.0%), tightness (126, 48.8%), and dull aching pain (66, 25.7%). Conclusions: T.T.H. is a prevalent condition with a significant impingement on academic work, and psychological health. Tension-type headache sufferers are advised to keep daily diaries to determine triggers, and plan for prevention and treatment progression.
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Fernández-de-Las-Peñas C, Plaza-Manzano G, Sanchez-Infante J, Gómez-Chiguano GF, Cleland JA, Arias-Buría JL, Navarro-Santana MJ. The importance of the local twitch response during needling interventions in spinal pain associated with myofascial trigger points: a systematic review and meta-analysis. Acupunct Med 2021; 40:299-311. [PMID: 34894759 DOI: 10.1177/09645284211056346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To compare the clinical effects of needling interventions eliciting local twitch responses (LTRs) versus needling without eliciting LTRs when applied to muscle trigger points (TrPs) associated with spinal pain of musculoskeletal origin. DATABASES AND DATA TREATMENT Electronic databases were searched for randomized or non-randomized clinical trials where one group received needling intervention where LTRs were elicited and was compared with another group receiving the same intervention without elicitation of LTRs in spinal pain disorders associated with TrPs. Outcomes included pain intensity, pain-related disability, and pressure pain thresholds. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool or ROBINS-I tool, methodological quality was assessed with the PEDro score, and quality of evidence was evaluated using the GRADE approach. RESULTS Six trials were included. The application of a needling intervention eliciting LTRs was associated with a significant reduction in pain intensity immediately after treatment (mean difference (MD): -2.03 points, 95% confidence interval (CI): -3.77 to -0.29; standardized MD (SMD): -1.35, 95% CI: -2.32 to -0.38, p = 0.02) when compared to the same needling intervention without elicitation of LTRs. No effect at short-term follow-up (MD: -0.20 points, 95% CI: -1.46 to 1.06, p = 0.75) was observed. No significant differences based on elicitation or non-elicitation of LTRs were found in related disability (SMD: -0.05, 95% CI: -0.41 to 0.30, p = 0.77) or pressure pain thresholds (MD: 23.39 kPa, 95% CI: -13.68 to 60.47, p = 0.22). DISCUSSION Low-level evidence suggests an immediate effect of obtaining LTRs during needling interventions on pain intensity, with no significant effects on related disability or pressure pain sensitivity in spinal pain disorders associated with muscle TrPs. REGISTRATION NUMBER OSF Registry-https://doi.org/10.17605/OSF.IO/5ZX9N.
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Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain.,Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Jorge Sanchez-Infante
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Guido F Gómez-Chiguano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.,Clínica Dinamia Fisioterapia. Madrid, Spain
| | - Joshua A Cleland
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - José L Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos (URJC), Alcorcón, Spain.,Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Marcos J Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain.,Rehabilitación San Fernando, Madrid, Spain
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Pei F, Hu WJ, Mao YN, Zhao YL. The efficacy of acupuncture combined with Bailemian capsule in the treatment of cervical spondylosis accompanied by headache, anxiety, and depression. Explore (NY) 2021; 18:533-538. [PMID: 34810135 DOI: 10.1016/j.explore.2021.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/20/2021] [Accepted: 10/30/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The present study aimed to investigate the efficacy of using acupuncture combined with Bailemian capsule to treat cervical spondylosis by observing the improvement in the degree of headache, anxiety, and depression suffered by patients. METHODS A total of 100 patients with cervical spondylosis of the cervical type were equally divided into a combination group and a control group using the random number table method. The patients in the combination group were treated with acupuncture combined with the oral administration of Bailemian capsule, while those in the control group were only treated with acupuncture. Patient self-assessment was conducted, comprising the visual analogue scale, the self-assessment scale for anxiety, and the self-assessment scale for depression. Before treatment and on the14th and 28th days of treatment, the therapeutic effects of the two treatment modalities on the cervical spondylosis and accompanying headache, anxiety, and depression were analyzed using the Hamilton anxiety scale, the Hamilton depression scale, the Pittsburgh sleep quality inventory, and the Neck Disability Index (%). RESULTS There were statistically significant differences between the two groups in all seven indicators at the different treatment time points (p < 0.01). The seven indicators were significantly reduced in both groups on the 14th and 28th days of treatment compared with before the treatment. Moreover, except for the Neck Disability Index results at 14 days, which did not differ between the groups (p = 0.37), all the other indicators were significantly lower in the combination group than in the control group on the 14th and 28th days of treatment (p < 0.01), and at the end of the treatment, the therapeutic effect was significantly better in the combination group than in the control group (p = 0.006). CONCLUSION Both acupuncture combined with Bailemian Capsule and acupuncture alone were effective in the treatment of cervical spondylosis, but the combination therapy was better than the acupuncture alone in improving the accompanying negative symptoms of headache, anxiety, and depression.
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Affiliation(s)
- Feng Pei
- Department of Chinese -Western Cooperative Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 050000,China
| | - Wei-Jia Hu
- The Preparation Room of the Fifth Hospital of Shijiazhuang City, Shijiazhuang, Hebei Province 050021,China
| | - Yi-Nan Mao
- The Second Department of Otorhinolaryngology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 050000,China
| | - Yu-Liang Zhao
- The Second Department of Otorhinolaryngology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 050000,China.
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Delussi M, Laporta A, Fraccalvieri I, de Tommaso M. Osmophobia in primary headache patients: associated symptoms and response to preventive treatments. J Headache Pain 2021; 22:109. [PMID: 34537019 PMCID: PMC8449918 DOI: 10.1186/s10194-021-01327-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/07/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Osmophobia, is common among primary headaches, with prevalence of migraine. The study aimed to evaluate prevalence and clinical characteristics of patients with osmophobia in a cohort of primary headache patients selected at a tertiary headache center. The second aim was to verify the possible predicting role of osmophobia in preventive treatment response in a sub cohort of migraine patients. METHODS This was an observational retrospective cohort study based on data collected in a tertiary headache center. We selected patients aged 18-65 years, diagnosed as migraine without aura (MO), migraine with aura (MA) or Chronic Migraine (CM), Tension-Type Headache (TTH); and Cluster Headache (CH). We also selected a sub-cohort of migraine patients who were prescribed preventive treatment, according to Italian Guidelines, visited after 3 months follow up. Patients were considered osmophobic, if reported this symptom in at least the 20% of headache episodes. Other considered variables were: headache frequeny, the migraine disability assessment (MIDAS), Allodynia Symptom Checklist, Self-rating Depression scale, Self-rating Anxiety scale, Pain intensity evaluated by Numerical Rating Scale-NRS- form 0 to 10. RESULTS The 37,9% of patients reported osmophobia (444 patients with osmophobia, 726 without osmophobia). Osmophobia prevailed in patients with the different migraine subtypes, and was absent in patients with episodic tension type headache and cluster headache (chi square 68.7 DF 7 p < 0.0001). Headache patients with osmophobia, presented with longer hedache duration (F 4.91 p 0.027; more severe anxiety (F 7.56 0.007), depression (F 5.3 p 0.019), allodynia (F 6 p 0.014), headache intensity (F 8.67 p 0.003). Tension type headache patients with osmophobia (n° 21), presented with more frequent headache and anxiety. A total of 711 migraine patients was visited after 3 months treatment. The change of main migraine features was similar between patients with and without osmophobia. CONCLUSIONS While the present study confirmed prevalence of osmophobia in migraine patients, it also indicated its presence among chronic tension type headache cases, marking those with chronic headache and anxiety. Osmophobia was associated to symptoms of central sensitization, as allodynia. It was not relevant to predict migraine evolution after first line preventive approach.
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Affiliation(s)
- Marianna Delussi
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy
| | - Anna Laporta
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy
| | - Ilaria Fraccalvieri
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy
| | - Marina de Tommaso
- Applied Neurophysiology and Pain Unit, SMBNOS Department, Aldo Moro University, Bari, Italy.
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DUYMAZ T. Efficacy of kinesio taping on pain, pain threshold and emotional status in tension-type headache. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2021. [DOI: 10.23736/s0393-3660.18.04034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Mapping Assessments Instruments for Headache Disorders against the ICF Biopsychosocial Model of Health and Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010246. [PMID: 33396262 PMCID: PMC7795912 DOI: 10.3390/ijerph18010246] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022]
Abstract
Headache disorders have a strong impact on sufferers’ lives. However, the “content” of assessment instruments addressing concepts, such as disability and quality of life (QoL), has not comprehensively been addressed. We searched SCOPUS for research papers in which outcome measures were used in adult populations of patients with migraine, tension-type headache (TTH), and cluster headache (CH). The content of single instruments was then mapped against the International Classification of Functioning, Disability, and Health. A total of 150 papers and 26 instruments were included: 15 addressed disability or impact, two addressed work-related difficulties, and nine addressed QoL. Few instruments were commonly used across the conditions and covered domains of functioning were impact on daily life activities, homework, school, and work-related tasks, leisure time, informal and family relations, pain, emotional difficulties, energy level, and impulse control. Most of the research is based on instruments that were developed for migraine, which is critical for CH, and the impact of headache disorders on work-related activities is poorly acknowledged. Further research is needed to expand the scope of headaches impact on daily life activities, and on environmental factors relevant to headache disorders to raise knowledge on the less represented areas, e.g., TTH impact.
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San-Antolín M, Rodríguez-Sanz D, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Martínez-Jiménez EM, López-López D, Calvo-Lobo C. Neuroticism Traits and Anxiety Symptoms are Exhibited in Athletes With Chronic Gastrocnemius Myofascial Pain Syndrome. J Strength Cond Res 2020; 34:3377-3385. [PMID: 33065704 DOI: 10.1519/jsc.0000000000003838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
San-Antolín, M, Rodríguez-Sanz, D, Becerro-de-Bengoa-Vallejo, R, Losa-Iglesias, ME, Martínez-Jiménez, EM, López-López, D, and Calvo-Lobo, C. Neuroticism traits and anxiety symptoms are exhibited in athletes with chronic gastrocnemius myofascial pain syndrome. J Strength Cond Res 34(12): 3377-3385, 2020-Common psychological factors, such as anxiety or neurotic personality traits, seem to be associated with pain suffered by athletes. Gastrocnemius muscles present a high prevalence for injury in athletes. These muscles are a region in which myofascial pain syndrome (MPS) frequently develops. Myofascial pain syndrome is characterized by the presence of active myofascial trigger points (MTrPs). This study compared different personality and anxiety symptoms between athletes with and without active MTrPs in the gastrocnemius. A case-control study was conducted in an outpatient clinic. Athletes who performed moderate or vigorous physical activity according to the International Physical Activity Questionnaire were included. Fifty paired-matched athletes with and without active MTrPs in their gastrocnemius muscles (n = 25 in each group) were recruited. Different personality traits (neuroticism, extraversion, psychoticism, and sincerity) and anxiety (state and trait) were evaluated by the Eysenck Personality Questionnaire and State-Trait Anxiety Inventory, respectively. Statistically significant differences (p < 0.01) with an effect size from moderate to large (d = 0.75-1.29) were found for greater neuroticism and sincerity traits in addition to state and trait anxiety in athletes with gastrocnemius MPS compared with healthy controls. In conclusion, athletes with gastrocnemius active MTrPs exhibited higher neuroticism and anxiety symptoms compared with healthy athletes. Mental health may play a key role in athletes with myofascial pain, and future studies should be performed to determine whether neuroticism-related and anxiety-related psychological care could be a key intervention in athletes with gastrocnemius active MTrPs to improve athletic performance and rehabilitation or prevent injuries.
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Affiliation(s)
- Marta San-Antolín
- Department of Psychology, European University of Madrid, Villaviciosa de Odón, Madrid, Spain
| | - David Rodríguez-Sanz
- Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
| | | | | | | | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, Ferrol, Spain
| | - César Calvo-Lobo
- Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Madrid, Spain
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Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain. Curr Opin Support Palliat Care 2020; 13:270-276. [PMID: 31313700 DOI: 10.1097/spc.0000000000000445] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Myofascial pain syndrome is a chronic pain condition characterized by the presence of myofascial trigger point, a hyperirritable painful spot involving a limited number of muscle fibers. The literature suggest that myofascial trigger points should be considered peripheral pain generators and this critical review will summarize recent findings concerning the clinical evaluation and the treatment of myofascial trigger points. RECENT FINDINGS The clinical features of myofascial trigger points and their contribution to the patient pain and disability have been detailed in several recent studies, which support the clinical relevance of the condition. Recent studies reported that manual palpation to identify MTrPs has good reliability, although some limitations are intrinsic to the diagnostic criteria. During the last decade, a plethora of treatments have been proposed and positive effects on pain and function demonstrated. SUMMARY The myofascial trigger point phenomenon has good face validity and is clinically relevant. Clinicians are encouraged to consider the contribution of myofascial trigger points to the patient's pain and disability through a careful medical history and a specific manual examination. Patients with myofascial trigger points will benefit from a multimodal treatment plan including dry needling and manual therapy techniques. Internal and external validity of research within the field must be improved.
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13
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Fernández-de-Las-Peñas C, Nijs J. Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm. J Pain Res 2019; 12:1899-1911. [PMID: 31354339 PMCID: PMC6590623 DOI: 10.2147/jpr.s154728] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/24/2019] [Indexed: 02/06/2023] Open
Abstract
Myofascial pain syndrome is a pain condition characterized by the presence of trigger points. Current evidence, mostly experimental studies, clearly supports a role of trigger points on peripheral and central sensitization since they are able to contribute to sensitization of peripheral nociceptors, spinal dorsal horn neurons, and the brainstem. Several interventions are proposed for treating trigger points, dry needling being one of the most commonly used by clinicians. There is no consensus on the clinical application of trigger point dry needling: some authors propose that local twitch responses should be elicited during the needling intervention to be effective, whereas others do not. The application of trigger point dry needling is able to reduce the excitability of the central nervous system by reducing peripheral nociception associated to the trigger point, by reducing dorsal horn neuron activity, and by modulating pain-related brainstem areas. However, the effects are mainly observed in the short-term, and effect sizes are moderateto small. Therefore, the current review proposes that the application of trigger point dry needling should be integrated into current pain neuroscience paradigm by combining its application with pain neuroscience education, graded exercise and manual therapy. Additionally, patient’s expectations, beliefs, previous experiences and patient–clinician interaction should be considered when integrating trigger point dry needling into a comprehensive treatment approach.
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Affiliation(s)
- César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.,Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Jo Nijs
- Faculty of Physical Education and Physiotherapy, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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Cigarán‐Méndez M, Jiménez‐Antona C, Parás‐Bravo P, Fuensalida‐Novo S, Rodríguez‐Jiménez J, Fernández‐de‐las‐Peñas C. Active Trigger Points Are Associated With Anxiety and Widespread Pressure Pain Sensitivity in Women, but not Men, With Tension Type Headache. Pain Pract 2019; 19:522-529. [DOI: 10.1111/papr.12775] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 12/16/2022]
Affiliation(s)
| | - Carmen Jiménez‐Antona
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos AlcorcónSpain
| | - Paula Parás‐Bravo
- Department of Nursing Universidad de Cantabria Cantabria Spain
- Nursing Group IDIVAL Santander Cantabria Spain
| | - Stella Fuensalida‐Novo
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos AlcorcónSpain
| | - Jorge Rodríguez‐Jiménez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos AlcorcónSpain
| | - César Fernández‐de‐las‐Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Universidad Rey Juan Carlos AlcorcónSpain
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Jull G, Hall T. Cervical musculoskeletal dysfunction in headache: How should it be defined? Musculoskelet Sci Pract 2018; 38:148-150. [PMID: 30270129 DOI: 10.1016/j.msksp.2018.09.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 09/13/2018] [Accepted: 09/20/2018] [Indexed: 02/08/2023]
Abstract
Neck pain commonly accompanies migraine and tension-type headache, but the literature is divided on whether this neck pain is a headache symptom or is associated with cervical musculoskeletal dysfunction. Clarification is essential for hypotheses on the pathogenesis of these headaches and their variants and for decisions on suitability of local neck treatments, both from research and clinical practice perspectives. Reasons for disparate findings could relate to participant selection in headache studies and/or the bases on which decisions on the presence of cervical musculoskeletal dysfunction are reached. Propositions towards gaining a clearer picture of migraine and tension-type headache related neck pain include first, stricter inclusion criteria and reporting of headache characteristics of study participants. Second, reliance on pain sensitivity or the presence of neck tenderness/trigger points as measures be discarded, as they are not uniquely tied to a musculoskeletal disorder. Instead, place reliance on tests of musculoskeletal (dys)function. Third, the values and interpretation of single measures or tests of impairment/dysfunctions can be non-informative and do not reflect the presentation of cervical musculoskeletal disorders. Rather, a typical presentation includes at a fundamental level, interrelated changes in cervical movement, segmental joint and muscle function. We advocate that these measures be adopted as the core set of related measures to define cervical musculoskeletal dysfunction in headache. This does not deter inclusion of other measures of interest or qualification.
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Affiliation(s)
- Gwendolen Jull
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia.
| | - Toby Hall
- School of Physiotherapy and Exercise Science, Curtin University, Australia.
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Fernández-De-Las-Peñas C, Arendt-Nielsen L. Improving understanding of trigger points and widespread pressure pain sensitivity in tension-type headache patients: clinical implications. Expert Rev Neurother 2017; 17:933-939. [DOI: 10.1080/14737175.2017.1359088] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- César Fernández-De-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Spain
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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