Abstract:
BACKGROUND : The management of patients presenting with chronic tension-type headache (CTTH) can be challenging for primary
health care practitioners. As with most chronic pain disorders, a multimodal management approach is frequently required. It has
been postulated that myofascial pain syndrome (MPS) and its hallmark myofascial trigger points (MTrPs) found in specific muscle
tissues may play a role in the chronic pain experienced by patients with CTTH. Little is known about the prevalence of MTrPs
in patients with CTTH, in primary health care settings on the African continent. This study therefore aimed to investigate the
prevalence of active MTrP’s in specific head and neck muscles/muscle groups in patients with CTTH.
METHODS : A prospective, cross-sectional and descriptive study was done in two primary health care facilities situated in Tshwane,
South Africa. The sample included 97 adult patients with CTTH. Five head and neck muscles/muscle groups were examined
bilaterally for active MTrPs. Outcome measures were the prevalence and distribution of active MTrPs in these patients.
RESULTS : Active MTrPs were found in 95.9% of the patients, the majority (74.2%) having four or more active MTrPs. The temporalis
muscles and suboccipital muscle group exhibited the highest number of active MTrPs (prevalence 87.6% and 80.4% respectively).
CONCLUSION : Our study suggests a strong association between MPS and CTTH in patients, presenting in the primary health care
setting. This indicates the importance of a musculoskeletal assessment of neck and pericranial muscles in patients with CTTH.
This can assist in determining the most appropriate treatment strategy in these patients.
