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The local and referred pain from myofascial trigger points in the temporalis muscle contributes to pain profile in chronic tension-type headache.
Clin J Pain. 2007 Nov-Dec; 23(9):786-92.CJ

Abstract

OBJECTIVE

To assess the local and referred pain areas and pain characteristics evoked from temporalis muscle trigger points (TrPs) in chronic tension-type headache (CTTH).

METHODS

Thirty CTTH patients and 30 age and sex-matched controls were studied. A headache diary was kept for 4 weeks to substantiate the diagnosis and record the pain history. Both temporalis muscles were examined for the presence of myofascial TrPs in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold were recorded.

RESULTS

Referred pain was evoked in 87% and 54% on the dominant and nondominant sides in CTTH patients, which was significantly higher (P<0.001) than in controls (10% vs. 17%, respectively). Referred pain spread to the temple ipsilateral to the stimulated muscle in both patients and controls, with additional referral behind the eyes in most patients, but none in controls. CTTH patients reported a higher local [visual analog scale (VAS): 5.6+/-1.2 right side, 5.3+/-1.4 left side] and referred pain (VAS: 4.7+/-2 right side, 3.5+/-2.8 left side) intensity than healthy controls (VAS: 0.8+/-0.7 right side, 0.7+/-0.7 left side for local pain; and 0.3+/-0.2 right side, 0.4+/-0.3 left side for referred pain) in both temporalis muscles (both, P<0.001). The local and referred pain areas were larger in patients than in controls (P<0.001). Twenty-three out of 30 CTTH patients (77%) had active TrPs in the temporalis muscle leading to their usual headache (17 patients on the right side; 12 on the left side, whereas 6 with bilateral active TrPs). CTTH patients with active TrPs in either right or left temporalis muscle showed longer headache duration than those with latent TrPs (P=0.004). CTTH patients showed significantly (P<0.001) lower pressure pain threshold (1.1+/-0.2 right side, 1.2+/-0.3 left side) as compared with controls (2.5+/-0.5 right side, 2.6+/-0.4 left side).

CONCLUSIONS

In CTTH patients, the evoked local and referred pain from active TrPs in the temporalis muscle and its sensory characteristics shared similar patterns as their habitual headache pain. Local and referred pain from active TrPs in the temporalis muscles may constitute one of the sources contributing to the pain profile of CTTH.

Authors+Show Affiliations

Department of Physical Therapy of Universidad Rey Juan Carlos, Madrid, Spain. cesarfdlp@yahoo.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18075406

Citation

Fernández-de-Las-Peñas, César, et al. "The Local and Referred Pain From Myofascial Trigger Points in the Temporalis Muscle Contributes to Pain Profile in Chronic Tension-type Headache." The Clinical Journal of Pain, vol. 23, no. 9, 2007, pp. 786-92.
Fernández-de-Las-Peñas C, Ge HY, Arendt-Nielsen L, et al. The local and referred pain from myofascial trigger points in the temporalis muscle contributes to pain profile in chronic tension-type headache. Clin J Pain. 2007;23(9):786-92.
Fernández-de-Las-Peñas, C., Ge, H. Y., Arendt-Nielsen, L., Cuadrado, M. L., & Pareja, J. A. (2007). The local and referred pain from myofascial trigger points in the temporalis muscle contributes to pain profile in chronic tension-type headache. The Clinical Journal of Pain, 23(9), 786-92.
Fernández-de-Las-Peñas C, et al. The Local and Referred Pain From Myofascial Trigger Points in the Temporalis Muscle Contributes to Pain Profile in Chronic Tension-type Headache. Clin J Pain. 2007 Nov-Dec;23(9):786-92. PubMed PMID: 18075406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The local and referred pain from myofascial trigger points in the temporalis muscle contributes to pain profile in chronic tension-type headache. AU - Fernández-de-Las-Peñas,César, AU - Ge,Hong-You, AU - Arendt-Nielsen,Lars, AU - Cuadrado,Maria Luz, AU - Pareja,Juan A, PY - 2007/12/14/pubmed PY - 2008/2/15/medline PY - 2007/12/14/entrez SP - 786 EP - 92 JF - The Clinical journal of pain JO - Clin J Pain VL - 23 IS - 9 N2 - OBJECTIVE: To assess the local and referred pain areas and pain characteristics evoked from temporalis muscle trigger points (TrPs) in chronic tension-type headache (CTTH). METHODS: Thirty CTTH patients and 30 age and sex-matched controls were studied. A headache diary was kept for 4 weeks to substantiate the diagnosis and record the pain history. Both temporalis muscles were examined for the presence of myofascial TrPs in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold were recorded. RESULTS: Referred pain was evoked in 87% and 54% on the dominant and nondominant sides in CTTH patients, which was significantly higher (P<0.001) than in controls (10% vs. 17%, respectively). Referred pain spread to the temple ipsilateral to the stimulated muscle in both patients and controls, with additional referral behind the eyes in most patients, but none in controls. CTTH patients reported a higher local [visual analog scale (VAS): 5.6+/-1.2 right side, 5.3+/-1.4 left side] and referred pain (VAS: 4.7+/-2 right side, 3.5+/-2.8 left side) intensity than healthy controls (VAS: 0.8+/-0.7 right side, 0.7+/-0.7 left side for local pain; and 0.3+/-0.2 right side, 0.4+/-0.3 left side for referred pain) in both temporalis muscles (both, P<0.001). The local and referred pain areas were larger in patients than in controls (P<0.001). Twenty-three out of 30 CTTH patients (77%) had active TrPs in the temporalis muscle leading to their usual headache (17 patients on the right side; 12 on the left side, whereas 6 with bilateral active TrPs). CTTH patients with active TrPs in either right or left temporalis muscle showed longer headache duration than those with latent TrPs (P=0.004). CTTH patients showed significantly (P<0.001) lower pressure pain threshold (1.1+/-0.2 right side, 1.2+/-0.3 left side) as compared with controls (2.5+/-0.5 right side, 2.6+/-0.4 left side). CONCLUSIONS: In CTTH patients, the evoked local and referred pain from active TrPs in the temporalis muscle and its sensory characteristics shared similar patterns as their habitual headache pain. Local and referred pain from active TrPs in the temporalis muscles may constitute one of the sources contributing to the pain profile of CTTH. SN - 0749-8047 UR - https://www.unboundmedicine.com/medline/citation/18075406/The_local_and_referred_pain_from_myofascial_trigger_points_in_the_temporalis_muscle_contributes_to_pain_profile_in_chronic_tension_type_headache_ L2 - https://doi.org/10.1097/AJP.0b013e318153496a DB - PRIME DP - Unbound Medicine ER -