Remedial massage therapy interventions including and excluding sternocleidomastoid, scalene, temporalis and masseter muscles for Chronic Tension Type Headaches: A case series.
This 6-week case series addressed four cases of chronic tension-type headache (CTTH) to investigate whether massage therapy interventions were more effective when muscles of the anterior neck, jaw and cranium were included. Four female clients suffering CTTH received six pre-determined massage therapy interventions, 45 minutes each, over a three week period. Case A and B (exclusion cases) received interventions addressing shoulder, posterior neck and occiput muscles, Case C and D (inclusions cases) received interventions addressing the same areas and sternocleidomastoid, scalene, temporalis and masseter muscles. Treatment strategies included myofascial trigger point release, neuromuscular therapy, and consideration of central sensitization mechanisms present in CTTH. Outcome measures of headache frequency (primary), intensity, and duration (secondary) were recorded via headache diaries issued to each participant for one week of baseline measures, 3 weeks of intervention, and a two-week runout period. Secondary measures also included a headache disability inventory (HDI) at baseline, conclusion of intervention and final measures. After final measures, clients were given stretching education and 4 weeks later, a follow-up phone conversation to note subjective headache reports. Results showed all cases had headache frequency and HDI score reductions, while intensity and duration measures fluctuated. At final measures, exclusion Case A and both inclusion cases (C and D) had headache frequency reductions to below CTTH diagnostic criteria from The International Headache Society (>15 headache affected days /month). These three cases also had clinically meaningful (>16%) HDI score reductions and subjectively reported continued improvements after study completion. Comparative results suggest there may be additional benefit in reducing headache frequency and disability with the inclusion of anterior neck, jaw and cranial muscles in the treatment of CTTH. The inclusion cases overall had a greater decrease in headache frequency and HDI, however, limited sample size makes it difficult to rule out outliers or individual variables influencing data. Further investigation is recommended.
Articles published in this journal are licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License (see http://creativecommons.org/ and http://creativecommons.org/licenses/by-nc-nd/3.0/ ). Accordingly, the following conditions apply: (a) Copyright for articles published in this journal is retained by authors, with first publication rights granted to the journal. (b) By virtue of their appearance in this open-access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings. (c) Derivative works are not allowed in that a user may not alter, transform, or add additional content to an article published in this journal.