Myofascial trigger-point therapy reduced the number, duration and severity of tension-type headaches among children ages 5 to 15, according to recent research.

The study, “Myofascial Trigger Points in Children With Tension-Type Headache: A New Diagnostic and Therapeutic Option,” involved nine girls with an average age of about 13 years. Each participant had been diagnosed with tension-type headaches and was attending a special headache outpatient clinic.

None of the children experienced migraines, and secondary headaches were ruled out by thorough medical testing. In addition, each participant presented with active myofascial trigger points.

Researchers examined the following muscles for trigger points: sternocleidomastoid, splenius capitis, upper trapezius, temporalis, semispinalis, levator scapulae, masseter and frontalis.

Following the finding of active myofascial trigger points, subjects received one hour of trigger-point-specific physiotherapy twice a week for four weeks. This involved such techniques as ischemic compression of the myofascial trigger points, local stretching of the taut band and passive stretching of the muscle combined with postisometric relaxation.

Each child was required to keep a diary every day for four weeks before the intervention began, every day during the four-week intervention period and each day up until the final visit with researchers, which occurred shortly after the last hands-on session.

In this diary, subjects recorded headache frequency, headache intensity on a visual analog scale, headache duration and the use of rescue medication, including which drug and the dosage.

Results of the research revealed a reduction in both headache intensity and frequency following the trigger-point therapy. Improvements were noted after two to three sessions, but the most significant changes took place after an average of 6.5 sessions.

At that point, headache frequency dropped from more than three days per week to one day per week, a 67.7 percent improvement. Headache intensity decreased from a 6.5 on the visual analog scale to 1.67 on the visual analog scale, a 74.3 percent improvement.

Headache duration also improved significantly, down to 1.3 hours per day after the trigger-point therapy, as compared to 6 hours per day before the intervention began.

“In our small group of patients with tension-type headache and active myofascial trigger points, we experienced a good response, namely a 68 percent reduction in headache frequency,” state the study’s authors. “Additionally, patients could be taught the release techniques for self-administering to maintain the achieved effect once the pilot study was completed.”

Authors: Celina von Stülpnagel, Peter Reilich, Andreas Straube, Jan Schäfer, Astrid Blaschek, Seung-Hee Lee, Wolfgang Müller-Felber, Volkmar Henschel, Ulrich Mansmann and Florian Heinen.

Sources: Dr von Haunersches Kinderspital Department of Pediatric Neurology and Developmental Medicine; Friedrich-Baur-Institute Department of Neurology; Institute for Medical Informatics, Biometrics and Epidemiology; and Ludwig-Maximilians-University, Munich, Germany. Originally published in the Journal of Child Neurology (April 2009) 24(4): 406-409.

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