Trigger Point Sensitivity Is a Differentiating Factor between Cervicogenic and Non-Cervicogenic Headaches: A Cross-Sectional, Descriptive Study.

Abstract

Purpose: A common factor in all forms of headache is the presence of myofascial trigger points (TrPs). The aim of this study was to compare the presentation of patients with cervicogenic headaches and patients with non-cervicogenic headaches in the sensitivity of TrPs in their upper trapezius, sternocleidomastoid, temporalis, and posterior cervical muscles. Method: This was a descriptive, cross-sectional study. The following variables were compared between patients with cervicogenic (n=20) and patients with non-cervicogenic (n=20) headaches: sensitivity (pain-pressure threshold) of TrPs in the upper trapezius, sternocleidomastoid, posterior cervical, and temporalis muscles (using a handheld, digital algometer); level of disability (using the Henry Ford Hospital Headache Disability Inventory questionnaire); demographics (age, sex); anthropometrics (BMI); and clinical presentation (duration and intensity of symptoms). The independent Student t-test and χ2 test were used to determine the differences between the two groups. Effect sizes (Cohen's d) were calculated when relevant. Results: The two groups were similar in level of disability, demographic and anthropometric data, and clinical presentation. However, TrP sensitivity in the right upper trapezius (p=0.006; Cohen's d=0.96) and the left upper trapezius (p=0.003; Cohen's d=1.06) muscles was higher in the cervicogenic group. Conclusions: Increased sensitivity of TrPs in the upper trapezius muscle may be used as a differentiating factor in the diagnosis of cervicogenic headaches. This finding emphasizes the importance of integrating this muscle into the rehabilitation programs of patients with cervicogenic headache.