Musculoskeletal abnormalities in chronic headache: A controlled comparisonof headache diagnostic groups

The presence of postural, myofascial, and mechanical abnormalities in patie nts with migraine, tension-type headache, or both headache diagnoses was co mpared to a headache-free control sample. Twenty-four control subjects were obtained from a convenience sampling and each was matched by age and sex t o three patients with headache tone with migraine [with or without aura], o ne with tension-type headache, and one with diagnoses of both migraine and tension-type headache [combined diagnosis] who had been previously assessed by a physical therapist at a headache clinic. Physical therapy assessment findings were compared among the four groups. There was a significant difference in the presence of postural abnormalitie s between the controls and the patients, with posture abnormalities more li kely to be present in those with headache. The patients,were also significa ntly more likely to have active trigger points and trigger points in the ne ck than were the control subjects. There were no significant group differen ces identified in the mechanical measures, nor were there any significant d ifferences among the three headache categories. Determination of the clinic al significance of these musculoskeletal abnormalities in patients with hea dache will require the development and testing of further standardized asse ssments as well as physical therapy treatment programs.