Prevalence of Posterior Myofascial Chain Tightness and Presence of Myofascial Trigger Points in Subjects with Cervicogenic Headache

Abstract

Background: Cervicogenic headache (CGH) is a secondary headache linked to cervical spine disorders and musculoskeletal dysfunction. Recent research suggests that the posterior myofascial chain, extending from the cervical region to the lower limbs, may contribute to CGH. Muscle tightness and trigger points (TrPs) in this chain can exacerbate headache symptoms. However, limited research on the prevalence of tightness and TrPs in the posterior kinetic chain highlights the need for further investigation to inform targeted treatments.

Objective: The main aim of this study is to determine the prevalence of tightness and the presence of TrPs in the muscles of the posterior myofascial chain in subjects with CGH.

Materials and method: A total of 1,283 participants were screened using the Cervicogenic Headache International Study Group criteria, identifying 188 with CGH. This cross-sectional study assessed muscle tightness and TrPs in the posterior kinetic chain at one point in time. Seventeen TrPs across the upper back, lower back, and lower limbs were examined by examiner 1. Muscle tightness in the trapezius, thoracolumbar fascia, piriformis, hamstrings, and gastrosoleus was evaluated by examiner 2 using a goniometer or measuring tape.

Results: Data show that participants with left or right CGH have higher tightness percentages in the trapezius (left: 96.93%, right: 98.88%), thoracolumbar fascia (89.89%), and hamstrings (left: 97.95%, right: 95.55%). TrPs were more in the occipital ridge (left: 84.69%, right: 86.66%), splenius capitis and cervicis (left: 65.30%, right: 61.11%), lower cervical spine (left: 90.81%, right: 96.66%), and rhomboid (left: 55.10%, right: 53.33%). A one-sample t-test, which compared the scores to normal values, revealed a significant difference (p = 0.0001) in tightness and TrPs in the posterior kinetic chain.

Conclusion: The findings indicate that individuals with CGH exhibit a high occurrence of muscle tightness and TrPs on the posterior myofascial chain on the affected side.