Headache is one of the most common problems seen in medical practice. Because of this is very important to have an effective treatment, and if physical therapist can do something about this, They will help many people with this problem.
The etiology of tension-type headache is unclear, but there is evidence to suggest that some forms may originate from sustained isometric contraction of muscles associated with the head and neck. This type of extended muscle contraction may result in local nutrient deficiencies due to ischemia, which can generate trigger points within muscles. A myofacial trigger point is defined as "a hyperirritable spot associated within a taut band of a skeletal muscle"; this spot is painful on compression and usually responds with a referred pain pattern distant from that spot. The activation of myofascial trigger points has also been implicated as a cause of headache. Massage therapy techniques, which act in part to increase blood flow to tissue, may also reduce the activity of a trigger point. Thus, it is possible that headaches originating from this etiology may be reduced with massage therapy.
Objective:
The objective of the study was to determine whether a regimented massage therapy program could have beneficial effects on the frequency, intensity, and duration of pain associated with chronic tension headache.
Methods:
Chronic tension headache sufferers received structured massage therapy treatment directed toward neck and shoulder muscles. Headache frequency, duration and intensity were recorded and compared with baseline measures. A 4-week measurement period prior to treatment was used to establish individual subjects’ baseline measures. Following the baseline period, a 4-week treatment program was initiated that included therapeutic massage and trigger-point treatment of the following 6 muscles: upper trapezius, sternocleidomastoid, suboccipital, splenius capitis, levator scapulae, and temporalis. In addition to massage, each session included stretching and muscle energy techniques.
Materials:
A logbook was completed daily by each subject every evening before retiring. The headache diary form was used to record number of headaches, intensity of most severe headache, and duration of longest headache for each day. Headache intensity was determined by a visual analog scale (0–100 mm, where 0 =no pain and 100 =most pain) Headache duration was recorded to the nearest quarter hour.
Subjects:
To participate in the study, candidates had to be nonsmokers aged 18 to 55 years who had experienced 2 to 3 headaches per week for at least the past 6 months. Four subjects completed all therapy sessions and diary entries.
Procedure:
Each subject received a total of eight 30-minute massage therapy sessions during the
4-week treatment period. The treatment protocol consisted of 6 distinct phases within the 30-minute time frame.
Phase 1—preparatory tissue warm-up (3 minutes)
Phase 2—myofascial release (5 minutes)
Phase 3—axial cervical traction (2 minutes)
Phase 4—trigger point therapy procedure (15 minutes)
Phase 5—facilitated stretching techniques (5 minutes)
Phase 6—session closure (3–5 minutes)
Results:
Compared with baseline values, headache frequency was significantly reduced within the first week of the massage protocol. The reduction of headache frequency continued for the remainder of the study (P = .009). The duration of headaches tended to decrease during the massage treatment period (P = .058). Headache intensity was unaffected by massage (P = .19).
Conclusions:
The results of this study suggest that massage therapy is effective in reducing the number of headaches per week in chronic tension headache sufferer.
On the basis of these study I conclude that pain associated with chronic tension headache can be alleviated through specific massage therapy treatments directed at cranial and cervical muscles.
This study for me is very interesting because I suffered headaches all my life, and I know now that my headaches can be cause of trigger points in neck and shoulder, and I can have massage therapy instead of other pharmacological treatments.
