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Regional myofascial pain syndrome and headache: Principles of diagnosis and management

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Abstract

Myofascial pain is frequently overlooked in dealing with headache pain. Myofascial pain is defined as pain and/or autonomic phenomena referred from active trigger points, with associated dysfunction. The trigger point is a focus of hyperirritability in the muscle, that when compressed, is locally tender, and if sensitized, gives rise to referred pain and tenderness. The therapy for myofascial pain requires enhancing central inhibition through pharmacology or behavioral techniques and simultaneously reducing peripheral inputs through physical therapies including exercises and trigger point-specific therapy.

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References and Recommended Reading

  1. Olesen J, Jensen R: Getting away from simple muscle contraction as a mechanism of tension-type headache. Pain 1991, 46:123–124.

    Article  PubMed  CAS  Google Scholar 

  2. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society [no authors listed]. Cephalalgia 1988, 8(suppl 7):1-96.

  3. Schoenen J, Bottin D, Hardy F, Gerard P: Cephalic and extracephalic pressure pain thresholds in chronic tension-type headache. Pain 1991, 47:145–149.

    Article  PubMed  CAS  Google Scholar 

  4. Reeves JL, Jaeger B, Graff-Radford SB: Reliability of the pressure algometer as a measure of myofascial trigger point sensitivity. Pain 1986, 24:313–321.

    Article  PubMed  CAS  Google Scholar 

  5. Steinder A: The interpretation of the sciatic radiation and the syndrome of low back pain. J Bone Joint Surg 1940, 22:28–34.

    Google Scholar 

  6. Drewes AM, Jennum P: Epidemiology of myofascial pain, low back pain, morning stiffness and sleep related complaints in the general population [abstract]. J Musculoskeletal Pain 1995, 3(suppl 1):68.

    Google Scholar 

  7. Travell JG, Simons DG: Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore: Williams and Wilkins; 1983.

    Google Scholar 

  8. Kellgren JH: Observations on referred pain arising from muscle. Clin Sci 1938, 3:175–190.

    Google Scholar 

  9. Kraft GH, Johnson EW, Laban MM: The fibrocytis syndrome. Arch Phys Med Rehabil 1968, 49:155–162.

    PubMed  CAS  Google Scholar 

  10. Graff-Radford SB: Myofascial pain: an overview. Semin Anesth 1985, 4:281–286.

    Google Scholar 

  11. Fisher AA, Chang CH: Objective documentation of myofascial trigger points by thermography [abstract]. Pain 1984, 1(suppl):S137.

    Article  Google Scholar 

  12. Simmons DS, Travell JG: Myofascial trigger points: a possible explanation. Pain 1981, 10:106–109.

    Article  Google Scholar 

  13. Jaeger B, Reeves JL: Quantification of changes in myofascial trigger point sensitivity with pressure algometer following passive stretch. Pain 1986, 27:203–210.

    Article  PubMed  CAS  Google Scholar 

  14. Jaeger B, Skootsky SA: Double blind controlled study of different myofascial trigger point injections techniques [abstract]. Pain 1987, 4(suppl):S292.

    Article  Google Scholar 

  15. Graff-Radford SB, Reeves JL, Chiu D: Effectiveness of transcutaneous electrical nerve stimulation on trigger point sensitivity. Pain 1989, 37:1–5.

    Article  PubMed  CAS  Google Scholar 

  16. Sola AE, Williams RL: Myofascial pain syndromes. Neurology 1956, 6:91–95.

    PubMed  CAS  Google Scholar 

  17. Awad EA: Interstitial myofibrositis: hypothesis of the mechanism. Arch Phys Med 1973, 54:440–443.

    Google Scholar 

  18. Fassbender HG: Pathology of Rheumatic Diseases. New York: Springer-Verlag; 1975:303–304.

    Google Scholar 

  19. Mc Naaulty W, Gevirtz RN, Hubbard DR, Berkoff GM: Needle electromyographic evaluation of trigger point response to a psychological stressor. Psychophysiology 1994, 31:313–316.

    Article  Google Scholar 

  20. Mense S: Referral of muscle pain new aspects. Pain Forum 1994, 3:1–9.

    Google Scholar 

  21. Mense S: Considerations concerning the neurobiological basis of muscle pain. Can J Physiol Pharmacol 1991, 9:610–616. This article helps to explain muscle pain referral.

    Google Scholar 

  22. Mense S: Nociception from skeletal muscle in relation to clinical muscle pain. Pain 1993, 54:241–289.

    Article  PubMed  CAS  Google Scholar 

  23. Simons DG: Neurophysiological basis of pain caused by trigger points. J Am Pain Soc J 1994, 3:17–19. This article serves to demonstrate the role muscle pain may play in myofascial pain from a clinical point of view.

    Google Scholar 

  24. Pedersen-Bjergaard U, Nielsen LB, Jensen K, et al.: Calcitonin gene related peptide, neurokinin A and substance P on nociception and neurogenic inflammation in human skin and temporal muscle. Peptides 1991, 12:333–337.

    Article  PubMed  CAS  Google Scholar 

  25. Fields HL, Heinricher M: Brainstem modulation of nociceptor-driven withdrawal reflexes. Ann N Y Acad Sci 1989, 563:34–44.

    Article  PubMed  CAS  Google Scholar 

  26. Olesen J: Clinical and pathophysiological observations in migraine and tension type headache explained by integration of vascular, supraspinal and myofascial inputs. Pain 1991, 46:125–132.

    Article  PubMed  CAS  Google Scholar 

  27. Ernberg M, Hadenberg-Magnusson B, Alstergren P, et al.: Pain, allodynia, and serum serotonin level in orofacial pain of muscular origin. J Orofac Pain 1999, 13:56–62.

    PubMed  CAS  Google Scholar 

  28. Graff-Radford SB, Reeves JL, Jaeger B: Management of headache: the effectiveness of altering factors perpetuating myofascial pain. Headache 1987, 27:186–190.

    Article  PubMed  CAS  Google Scholar 

  29. Mennell JM: Spray-stretch for relief of pain from muscle spasm and myofascial trigger points. J Am Pod Assoc 1976, 66:873–876.

    CAS  Google Scholar 

  30. Jaeger B: Myofascial referred pain patterns: the role of trigger points. CDA J 1985, 13:27–32.

    PubMed  CAS  Google Scholar 

  31. Graff-Radford SB: Treatment contracting for chronic pain patients. Los Angeles Psychologist 1999, 13:9–26.

    Google Scholar 

  32. Maitland GD: Vertebral Manipulation, edn 4. London: Butterworth; 1977.

    Google Scholar 

  33. Solberg WK: Temporomandibular disorders: masticatory myalgia and its management. Br Dent J 1986, 160:379–385.

    Article  PubMed  CAS  Google Scholar 

  34. Reeves JL: EMG-biofeedback reduction of tension headaches: a cognitive skills training approach. Biofeedback Self Regul 1976, 1:217–225.

    Article  PubMed  CAS  Google Scholar 

  35. Holroyd KA, Andresik F, Westbrook T: Cognitive control of tension headaches: a cognitive skills training approach. Cognitive Ther Res 1977, 1:121–133.

    Article  Google Scholar 

  36. Sharav Y, Singer E, Schmidt E, et al.: The analgesic effect of amitriptyline on severe facial pain. Pain 1987, 31:199–203.

    Article  PubMed  CAS  Google Scholar 

  37. Fogelholm R, Murros K: Tizanidine in chronic tension type headache: a placebo controlled double blind cross over study. Headache 1992, 32:509–513.

    Article  PubMed  CAS  Google Scholar 

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Graff-Radford, S.B. Regional myofascial pain syndrome and headache: Principles of diagnosis and management. Current Science Inc 5, 376–381 (2001). https://doi.org/10.1007/s11916-001-0028-8

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