Asociación de puntos gatillo miofasciales en la cefalea tensional crónica y episódica

Abstract

Objective To analyze the data from two of our studies in order to compare the association of myofascial trigger points (TrPs) in patients with chronic (CTTH) and frequent episodic tension type headache (ETTH). Material and methods Twenty-five patients with CTTH, 15 subjects with frequent ETTH, and 25 healthy controls (HC) were included. A headache diary was kept for 4 weeks to record the pain history. A blinded assessor examined all the participants in search for TrPs in the trapezius, sternocleidomastoid and temporalis muscles. TrPs were diagnosed according to the following criteria: 1, presence of a taut band within the muscle; 2, presence of a hypersensitive spot in the taut band; 3, local twitch response elicited by snapping palpation, and 4, referred pain elicited by palpation of the TrP. TrPs that evoked a familiar pain were considered active, and those that evoked a non-familiar pain were considered latent. Results Patients showed a greater number of myofascial TrPs compared to controls (F=33.44; P<0.001). The presence of latent TrPs was not significantly different between groups, but active muscle TrPs were only present in patients. The distribution of muscle TrPs (either active or latent) was similar in both groups of patients (0.45<OR<1.5). The total number of TrPs in the analyzed muscles did not show any relationship with the headache parameters. Conclusions Patients with CTTH and frequent ETTH show TrPs in the cranio-cervical muscles in a similar proportion. Tension-type headache may at least partly be explained by the referred pain originated in TrPs of the cranio-cervical muscles.