A head-and-neck massage resulted in improved heart-rate variability, decreases in tension-anxiety and anger-hostility, and a reduction in head pain among research participants with chronic tension-type headaches.

The study, “Short-Term Effects of Manual Therapy on Heart Rate Variability, Mood State, and Pressure Pain Sensitivity in Patients with Chronic Tension-Type Headache: A Pilot Study,” involved 11 subjects, ages 20 to 68, all of whom had been diagnosed by a neurologist with chronic tension-type headaches.

At each of two intervention visits, the study’s subjects were randomly assigned to receive either head-and-neck massage or a placebo protocol, which consisted of detuned ultrasound to the head and neck regions.

The head-and-neck massage involved manual therapy aimed to inactivate trigger points in the head, neck and shoulder muscles. Various trigger-point techniques, such as pressure release, muscle energy and soft-tissue techniques, were applied to these muscles. Each session lasted roughly 40 minutes.

In the placebo sessions, detuned ultrasound was applied on the same head-and-neck muscles for about 40 minutes. The position of the participant and the areas of the body addressed were identical for both groups.

Outcome measures for this study included a 10-point self-assessment of current pain status, as well as a Profile of Mood States questionnaire that evaluated subjects’ moods in six areas: tension-anxiety, depression-dejection, anger-hostility, vigor, fatigue and confusion.

Electrocardiogram recordings were employed to assess heart rate among the subjects, and an electronic algometer was used to determine each participant’s pressure pain threshold. According to the study’s authors, the pressure pain threshold is defined as the “minimal amount of pressure required for the sense of pressure to first change to pain.”

All of these evaluations were conducted right before each intervention session, immediately after each intervention session and 24 hours following these sessions.

“The results of our study showed that a single session of a manual therapy protocol aimed to inactivate muscles [trigger points] decreases emotional tension and increases [heart-rate variability] immediately after treatment, as compared with detuned ultrasound in patients with [chronic tension-type headaches],” state the study’s authors.

For subjects in the massage group, current status of head pain remained reduced 24 hours after the intervention as well. However, none of the other improvements were present in the massage group 24 hours after the intervention.

“Further studies investigating the effects of numerous treatment sessions are needed to elucidate the clinical relevance of the current findings,” state the study’s authors.

Authors: Cristina Toro-Velasco, Manuel Arroyo-Morales, César Fernández-de-las-Peñas, Joshua A. Cleland and Francisco J. Berrero-Hernández.

Sources: Health Sciences School, Universidad Granada, Spain; Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Franklin Pierce University, Concord, New Hampshire; Concord Hospital, New Hampshire; Regis University, Denver, Colorado; University Hospital San Cecilio, Granada, Spain. Originally published in Journal of Manipulative and Physiological Therapeutics, September 2009, 32 (7): 527-535.

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