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Chiropractic Research Review

Pain Pressure Thresholds in Tension-Type Headaches

Tension headaches (characterized by constant pain in one area or the entire head; sore muscles with trigger points in the neck and upper back; lightheadedness; and dizziness) affect more than 70% of the population.

The underlying mechanism behind tension headaches may be tender pericranial and neck muscles, although it is unclear whether these muscular sensitivities are the cause of the headaches or merely a consequence.

Pressure pain thresholds and responses to painful mechanical stimuli were obtained from 20 subjects with episodic tension-type headache (TTH) in a study that evaluated the role of muscle tenderness in the pathogenesis of the condition. Tender points in the temporalis and trapezius musculature were examined, along with nontender points in the temporalis and Achilles tendon. Measurements were taken on subjects when they were free from headaches and when they had headaches.

Results: Subjects' reported sensitivity levels did not differ based on the presence or absence of tension-type headache, suggesting that muscle sensitivity in TTH sufferers may be a constant. Sensitivity levels of tender and nontender points also did not vary, suggesting that the underlying mechanism or effect of TTH may not be restricted to tender muscles. The authors believe that these findings emphasize the potential contribution of central nociceptors in the development of tension-type headache.

Bove GM, Nilsson N. Pressure pain threshold and pain tolerance in episodic tension-type headache do not depend on the presence of headache. Cephalalgia 1999:19, pp174-178.

Chiropractic Research Review

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