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Jes Olesen systematically described pericranial tenderness in migraine patients, both during and outside of migraine attacks, leading to speculations that myofascial mechanisms may be involved in migraine.
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Several mechanisms have been proposed to be involved in its pathophysiology including vascular, peripheral and central mechanisms. Migraine affects 16% of the population in Europe with high individual and socioeconomic costs. This suggests myofascial trigger points are accumulated over time as a consequence of TTH rather than contributing to the pathophysiology. However, the number of active myofascial trigger points is higher in adults compared with adolescents regardless of no significant association with headache parameters. Active myofascial trigger points in pericranial muscles in tension-type headache patients are correlated with generalized lower pain pressure thresholds indicating they may contribute to a central sensitization. Whether myofascial trigger points contribute to an increased migraine burden in terms of frequency and intensity is unclear.Īctive myofascial trigger points are prevalent in tension-type headache coherent with the hypothesis that peripheral mechanisms are involved in the pathophysiology of this headache disorder. These findings may imply a causal bottom-up association, but studies of migraine patients with comorbid fibromyalgia syndrome suggest otherwise. All intervention studies aiming at trigger points are positive, but this needs to be further verified in placebo-controlled environments.
#TRAVELL AND SIMONS HEAD PAIN PATTERNS MANUAL#
Manual palpation can trigger migraine attacks. Ultrasound is the most promising of these modalities and may be used to identify MTrPs if specific methods are used, but there is no precise description of a gold standard using these techniques, and they have yet to be evaluated in headache patients.Īctive myofascial trigger points are prevalent in migraine patients. Different modalities have been used to assess myofascial trigger points including ultrasound, microdialysis, electromyography, infrared thermography, and magnetic resonance imaging.