Among people with tension-type headaches, the use of positional release therapy (PRT) reduced the frequency and duration of these headaches and also decreased the number of pills taken for pain relief, according to recent research.

The study, “The effect of trigger point management by positional release therapy on tension type headache,” involved a total of 30 people who were diagnosed with tension-type headaches and referred to a neurology clinic.

Subjects were included in the study only if the presence of active trigger points was confirmed. The researchers searched for these active trigger points in the upper trapezius, sternocleidomastoid, subocciptal, cervical multifidus, rotators and interspinalis muscles.

Participants were randomly assigned to either the PRT group or the medication group. For people in both groups, there was a two-week baseline phase, a two-week treatment phase and a two-week follow-up phase.

Throughout each of these two-week periods, subjects were asked to keep a headache diary, in which they recorded the days on which headaches occurred, the intensity of the headache from zero to 10, the number of hours each headache persisted and the number of pills used to relieve the pain associated with each headache.

These were the main outcome measures for both groups. For subjects in the PRT group, the sensitivity of trigger points was an additional outcome measure. This was assessed at the end of each two-week phase, using a zero to 10 pain scale and a digital force gauge.

During the two-week baseline phase, participants in both groups were instructed to avoid the use of any drugs except for NSAID tablets for pain relief when they experienced a headache.

For the two-week treatment phase, subjects in the medication group used routine medications for tension-type headaches, including NSAID tablets and other pills prescribed to relieve pain.

Those participants assigned to the PRT group received five sessions of PRT during the two-week treatment phase. Subjects were instructed to avoid the use of any drugs for eight hours before each PRT session.

During the PRT appointments, “each trigger point was treated in a specially defined position of comfort,” state the study’s authors. “The position of comfort produced optimal relaxation of the involved tissues.”

Results of the research revealed a significant decrease in headache frequency and duration, as well as the number of pain pills taken, following the treatment phase for subjects in both groups. After the follow-up phase, these improvements remained only among subjects in the PRT group. Participants in the PRT group also showed a significant reduction in trigger-point sensitivity after the treatment phase and the follow-up phase.

“Based on the results of this study, both PRT and medical therapy were equally effective,” state the study’s authors. “Thus, it is suggested PRT can be a treatment choice for patients with [tension-type headache].”


Authors: Ali Ghanbari, Abbas Rahimijaberi, Marzieh Mohamadi, Leila Abbasi and Fahimeh Kamali Sarvestani.

Sources: Neurology Department, Faculty of Neurology Center, Shiraz University of Medical Sciences, Shiraz, Iran. Originally published in 2012 in NeuroRehabilitation, 30, 333-339.