Myofascial Trigger Point Release Massage Therapy Relieves Tension-Type Headaches
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Abdulrahman Rahim
Moraska AF, Stenerson L, Butryn N, Krutsch JP, Schmiege SJ, Mann JD. Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: a randomized, placebo-controlled clinical trial. Clin J Pain. 2015;31(2):159-168. doi:10.1097/AJP.0000000000000091.
As a result of the high prevalence of tension-type headache (TTH) and adverse effects from analgesic pharmaceutical treatment, there is interest in nonpharmacologic treatment options. Researchers in the United States have examined one of these options, focusing on the efficacy of using trigger point release (TPR) massage therapy on myofascial trigger points (MTrPs) to decrease headache pain.
This randomized placebo-controlled trial included 56 participants with TTH. Outcomes were measured during the 4 weeks before treatment, 6 weeks of treatment, and 4 weeks after treatment cessation. Participants were divided into a massage (n=17), placebo (n=19), or wait-list (n=20) group. Those in the massage group received a standardized treatment, which included TPRs aimed at the MTrPs in the sternocleidomastoids, suboccipital, and upper trapezius muscles. The massages were administered by massage therapists who had previous experience in MTrPs identification and had completed training sessions to ensure treatment standardization. Detuned ultrasonography was used in the placebo group. The wait-list group received no treatments but was involved in all outcomes measured. Six participants withdrew from the trial.
Headache diaries, maintained by all participants, showed that compared with baseline, a significant decrease in headache frequency occurred for the massage (P=.0003) and placebo (P=.013) groups. However, the diaries revealed no significant differences in the groups regarding headache duration, headache intensity, or medication use. Headache Disability Inventory scores showed a significant decrease in the massage group (P=.0003). However, both the massage (P=.0002) and placebo (P=.011) groups showed significant decreases in Headache Impact Test scores. After the treatment portion of the study, 84.7% of the massage, 50% of the placebo, and 0% of the wait-list groups reported improvements (P<.001). Pressure-pain thresholds were assessed bilaterally in the muscles massaged and were found to have significant improvements in the massage group (P<.002 for all outcomes).
Although the exact cause of TTH is still unknown, this study suggests that MTrPs are a contributing factor in headache pain and supports the use of TPR massage therapy to treat patients with TTH.
© 2016 American Osteopathic Association
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