MUSCULOSKELETAL CHANGES IN STUDENTS WITH CHRONIC AND EPISODIC HEADACHE
Keywords:
primary headache, migraine, tension-type headache, trigger points, masticatory musclesAbstract
Introduction: The frequency of headache seems to be related to the presence of trigger points (PG) in the masticatory muscles, but few studies have been done on the association between these two conditions. Objective: Associate the frequency of PG in the masticatory muscles with the frequency of headache. Materials and Methods: We evaluated 94 volunteers, aged between 18 and 30 years of both sexes, and excluded those who reported having systemic diseases. Headache was assessed through a questionnaire and PGs were evaluated in the masseter and temporal muscles bilaterally through palpation performed by a trained and blind evaluator for the diagnosis of headache. Statistical analysis was performed using the Shapiro-Wilk W tests, ANOVA, Chi-square (χ2) with Yates correction and confidence interval. The level of statistical significance adopted was p ≤ 0.05. Results: A total of 94 volunteers, n = 73 (77.66%) in the episodic group (GE), mean headache frequency of 8.71 and n = 21 in the chronic group (GC), mean frequency of 17.86, females prevalence in both groups (P <0.03). The CG presented a higher frequency of trigger points (p <0.02), especially in the masseter muscle, in addition to a greater chance of having trigger points OR = 3.2 (CI = 1.55-5.33) compared to the volunteers Episodic headache (SG) OR = 1.2 (CI = 0.24-2.43) demonstrating the association of headache frequency with PG. Conclusion: Trigger points in the masticatory region are clinically associated with an increased frequency of headache suggesting that the presence of these points may contribute to chronicity of headache.
References
WORLD HEALTH ORGANIZATION. Headache Disorders. Disponível em: <http://www.who.int/mediacentre/factsheets/fs277/en/> Acesso em: 28 de Março de 2018.
SOCIEDADE BRASILEIRA DE CEFALEIA. Dia Nacional do Combate à Cefaleia. Disponível em: <https://sbcefaleia.com.br/noticias.php?id=321/> Acesso em: 05 de Março de 2018.
PRENCIPE, M.; CASINI, A. R.; FERRETTI, C. et al. Prevalence of headache in an elderly population: Attack frequency, disability, and use of medication. J. Neurol. Neurosurg. Psychiatry., v. 70, n. 3, p. 377–381, 2001.
STARLING, A. J. Diagnosis and Management of Headache in Older Adults. Mayo Clin. Proc., v. 93, n. 2, p. 252–262, 2018.
ADELBORG, K.; SZÉPLIGETI, S. K.; HOLLAND-BILL, L. et al. Migraine and risk of cardiovascular diseases: Danish population based matched cohort study. B.M.J., p. k96, 2018.
VINCENT, M.; WANG, S. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia, v. 38, n. 1, p. 1–211, 2018.
GONÇALVES, M. C. Frequência e severidade da disfunção temporomandibular em mulheres com migrânea e migrânea crônica. Dissertação ( Mestrado em Ciências da Saúde Aplicadas ao Aparelho Locomotor). São Paulo: Universidade de São Paulo, 2010.
CALANDRE, E. P.; HIDALGO, J.; GARCÍA-LEIVA, J. M. et al. Trigger point evaluation in migraine patients: An indication of peripheral sensitization linked to migraine predisposition? Eur. J. Neurol., v. 13, n. 3, p. 244–249, 2006.
FERRACINI, G. N.; CHAVES, T. C.; DACH, F. et al. Relationship between Active Trigger Points and Head/Neck Posture in Patients with Migraine. Am. J. of Phys. Med. Rehabil., v. 95, n. 11, p. 831–839, 2016a.
FERRACINI, G. N.; FLORENCIO, L. L.; DACH, F. et al. Myofascial trigger points and migraine-related disability in women with episodic and chronic migraine. Clin. J. Pain, v. 33, n. 2, p. 109–115, 2016.
FERNÁNDEZ-DE-LAS-PEÑAS, C.; CAMINERO, A. B.; MADELEINE, P. et al. Multiple active myofascial trigger points and pressure pain sensitivity maps in the temporalis muscle are related in women with chronic tension type headache. Clin. J. Pain, v. 25, n. 6, p. 506–512, 2009.
FERNÁNDEZ-DE-LAS-PEÑAS, C.; GE, H.; ARENDT-NIELSEN, L. et al. The local and referred pain from myofascial trigger points in the temporalis muscle contributes to pain profile in chronic tension-type headache. Clin. J. Pain., v. 23, n. 9, p. 786–792, 2007.
STUGINSKI-BARBOSA, J.; SPECIALI, J. G. Frequency of headache among the employees of a rubber company in the state of São Paulo, Brazil. São Paulo Med. J., v. 129, n. 2, p. 66-72, 2011.
SIMONS, D. G.; TRAVELL, J. G.; SIMONS, L. S. Dor e Disfunção Miofascial. Manual de pontos-gatilho. 2ª ed. Porto Alegre: Artmed, 2005. 800 p.
PALACIOS-CEÑA, M.; WANG, K.; CASTALDO, M. et al. Trigger points are associated with widespread pressure pain sensitivity in people with tension-type headache. Cephalalgia, v. 38, n. 2, p. 237-245, 2016.
PALACIOS-CEÑA, M.; FERRACINI, G. N.; FLORENCIO, L. L. et al. The number of active but not latent trigger points associated with widespread pressure pain hypersensitivity in women with episodic migraines. A.A.P.M., v. 18, n. 12, p. 2485-2491, 2017.
FERNÁNDEZ-DE-LAS-PEÑAS, C.; CUADRADO, M. L.; GERMIN, R. D. et al. Refered pain from the trochlear region in tension-type headache: A myofascial trigger point from the superior oblique muscle. Headache, v. 45, n. 6, p. 731-737, 2005.
GONÇALVES, M. C.; FLORENCIO, L. L.; CHAVES, T. C. et al. Do women with migraine have higher prevalence of temporomandibular disorders? Braz. J. Phys. Ther., v. 17, n. 1, p. 64–68, 2013.
SILVA, B. B. B. Frequência e severidade de sinais e sintomas de Disfunção Temporomandibular e das Cefaleias primárias em estudantes do curso de fisioterapia. In: CARVALHO, S. T. R. F.; REGO, A. S.; SOARES, K. V. B. C. Algias Corporais: Coletânea de Pesquisas em Fisioterapia. São luís, 2017 p. 8-19.
BENDTSEN, L. Central sensitization in tension-type headache - possible pathophysiological mechanisms. Cephalalgia, v. 20, n. 5, p. 486-508, 2000.
18FERNÁNDEZ-DE-LAS-PEÑAS, C.; CUADRADO, M. L.; PAREJA, J. A. Myofascial trigger points, neck mobility and forward head posture in unilateral migraine. Cephalalgia, v. 26, n. 9, p. 1061-1070, 2006.
