Myofascial Trigger Points, Neck Mobility and Forward Head Posture in Unilateral Migraine
- 1 September 2006
- journal article
- research article
- Published by SAGE Publications in Cephalalgia
- Vol. 26 (9), 1061-1070
- https://doi.org/10.1111/j.1468-2982.2006.01162.x
Abstract
This paper describes the differences in the presence of myofascial trigger points (TrPs) in the upper trapezius, sternocleidomastoid, temporalis and suboccipital muscles between unilateral migraine subjects and healthy controls, and the differences in the presence of TrPs between the symptomatic side and the nonsymptomatic side in migraine subjects. In addition, we assess the differences in the presence of both forward head posture (FHP) and active neck mobility between migraine subjects and healthy controls and the relationship between FHP and neck mobility. Twenty subjects with unilateral migraine without side-shift and 20 matched controls participated. TrPs were identified when there was a hypersensible tender spot in a palpable taut band, local twitch response elicited by the snapping palpation of the taut band and reproduction of the referred pain typical of each TrP. Side-view pictures were taken in both sitting and standing positions to measure the cranio-vertebral angle. A cervical goniometer was employed to measure neck mobility. Migraine subjects showed a significantly greater number of active TrPs ( P < 0.001), but not latent TrPs, than healthy controls. Active TrPs were mostly located ipsilateral to migraine headaches ( P < 0.01). Migraine subjects showed a smaller cranio-vertebral angle than controls ( P < 0.001), thus presenting a greater FHP. Neck mobility in migraine subjects was less than in controls only for extension ( P = 0.02) and the total range of motion in flexion/extension ( P = 0.01). However, there was a positive correlation between the cranio-vertebral angle and neck mobility. Nociceptive inputs from TrPs in head and neck muscles may produce continuous afferent bombardment of the trigeminal nerve nucleus caudalis and, thence, activation of the trigeminovascular system. Active TrPs located ipsilateral to migraine headaches might be a contributing factor in the initiation or perpetuation of migraine.Keywords
This publication has 26 references indexed in Scilit:
- Migraine — Current Understanding and TreatmentThe New England Journal of Medicine, 2002
- Aspects on the Pathophysiology of Migraine and Cluster HeadacheBasic & Clinical Pharmacology & Toxicology, 2001
- Further Clinical Clarification of the Muscle Dysfunction in Cervical HeadacheCephalalgia, 1999
- Lost Workdays and Decreased Work Effectiveness Associated With Headache in the WorkplaceJournal of Occupational and Environmental Medicine, 1997
- Musculoskeletal Dysfunction of the Neck in Migraine and Tension HeadacheHeadache: The Journal of Head and Face Pain, 1993
- Incidence of Common Postural Abnormalities in the Cervical, Shoulder, and Thoracic Regions and Their Association with Pain in Two Age Groups of Healthy SubjectsPTJ: Physical Therapy & Rehabilitation Journal, 1992
- Stimulation of craniofacial muscle afferents induces prolonged facilitatory effects in trigeminal nociceptive brain-stem neuronesPain, 1992
- Epidemiology of headache in a general population—A prevalence studyJournal of Clinical Epidemiology, 1991
- Clinical and pathophysiological observations in migraine and tension-type headache explained by integration of vascular, supraspinal and myofascial inputsPain, 1991
- Lateralization of Headache: Possible Role of an Upper Cervical Trigger PointCephalalgia, 1989