Open AccessPressure Pain and Isometric Strength of Neck Flexors Are Related in Chronic Tension-Type Headache
Author(s) -
René Castien
Publication year - 2015
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj/2015.18.e201
Subject(s) - isometric exercise , medicine , neck pain , physical therapy , anesthesia , peripheral , alternative medicine , pathology
Background: In patients with chronic tension-type headache (CTTH) changes in pressure pain inthe cervical region are associated with peripheral or central sensitization. It is hypothesized that anincrease of isometric strength of neck flexors would lead to a decrease of pressure pain in CTTH,as an expression of reduced peripheral or central sensitizationObjective: In this study we aimed to analyze the correlation between change in isometric strengthof the neck flexors and change in pressure pain scores (PPS) in patients with CTTH.Study Design: Comparative analysis of data from previous study.Setting: Primary healthcare center.Methods: Data from 145 patients with CTTH who underwent a manual therapy programincluding isometric strength training of the neck flexors were analyzed at 8 and 26 weeks posttreatment. PPS were measured as a total of pain scores on a numeric rating scale (score 0 to 10)on application of a pressure stimulus of 3kg/cm at 8 cervical- and suboccipital muscles. Isometricstrength of the neck flexors was measured in seconds. Correlations were computed betweenchanges in PPS and isometric neck flexor strength.Results: Isometric strength of neck flexors scored significantly different compared to baselinemeasurement (mean 30.0 seconds, sd:25.2), and increased with a mean difference of 17.33seconds (95%CI: 20.61 to 14.05) at 8 weeks and 19.18 seconds (95%CI: 23.48 to 14.87) at 26weeks. Similarly, compared to PPS baseline measurement (31.6 points, sd:18.6), mean differencein PPS was significantly decreased at 8 and 26 weeks: -11.3 points (95%CI: -8.77 to -13.83) and-11.15 points (95%CI: -8.31 to -13.99). There is a negative correlation between changes in PPSand changes in isometric strength of neck flexors which is weak at 8 weeks (r = -0.243, P = 0.004)and moderate at 26 weeks (r = -0.318, P < 0.000).Limitations: Correlational analysis.Conclusion: Decrease in PPS correlates with increases in isometric strength of neck flexors inpatients with CTTH in short- and long-termKey words: Chronic tension-type headache, pressure pain, neck flexors, manual therapy,sensitization, isometric strength, cervical spine