Abstract

Background
Myofascial pain syndrome (MPS) is a regional pain syndrome characterized in part by a trigger point in a taut band of skeletal muscle and its associated referred pain. Myofascial pain due to trigger points has been reported as the most prevalent cause of painful symptoms in temporomandibular disorders. Similarly, sufficient evidence exists supporting a substantial role of myofascial trigger point pain in chronic tension-type and migraine headaches. However, the clinical features of MPS have rarely been studied in the primary headache in Korea.
Methods
This study was a retrospective, single-center chart review. Forty-two patients with primary headache and MPS, who were followed up for longer than 3 months and did not suffer from other diseases except for headache, were recruited from October 2003 to April 2004. They were divided into chronic tension-type headache (24, 57%), chronic migraine (16, 38%), and cluster headache (2, 5%). We treated a series of 42 patients with myofascial trigger point by injecting 0.5% lidocaine with multiple needle penetrations in a fanwise pattern.
Results
Trigger point injection was shown to produce complete headache elimination in 58.3% of chronic tension-type headache patients, 62.5% of chronic migraine patients, and 100% of cluster headache patients. The most common muscle that produced headache was sternocleidomastoid muscle and trapezius muscle.
Conclusion
We should understand myofascial trigger points for better treatment of the primary headache patients. The intensity of myofascial pain due to trigger points should not be underestimated as patients have rated it as equal or slightly greater than pain from other causes. Korean Journal of Headache 6(2):137-146, 2005