Pericranial tenderness in females with episodic cervical headache versus asymptomatic controls

Abstract

Objectives. To compare pericranial tenderness of females with episodic cervical headache versus matched asymptomatic controls. Methods and Material. Through a single-blind cross-sectional study pericranial tenderness was compared between 20 females with episodic cervical headache (29.4±13.2 years) and 20 age-and gender-matched asymptomatic controls (30.1±13.7 years). Pericranial tenderness was bilaterally measured in a headache free period with the ‘Total Tenderness Score’ in the suboccipital, temporal, frontal, masseter, upper trapezius, levator scapula and sternocleidomastoid muscle insertions. Passive cervical mobility, headache intensity, frequency and duration were secondary outcomes. Analysis was done with a 95% confidence level (SPSS version 22). The Mann-Whitney U-test was used to compare pericranial, cephalic, cervical and muscle specific tenderness between groups. Correlations between 1) passive cervical mobility and 2) headache characteristics and the total tenderness score were estimated with Spearman’s rho. Results. The Headache-group (1.25±0.89) showed a two time higher (p<0.05) pericranial total tenderness score compared to the Control-group (0.62±0.70). Higher (p<0.05) scores were observed for the left suboccipital, temporal, masseter, upper trapezius, levator scapula and sternocleidomastoid muscles and the right suboccipital, frontal, upper trapezius and levator scapula muscles. Grouping the tenderness scores into cervical (suboccipital, upper trapezius, levator scapula, sternocleidomastoid) and cephalic (frontal, temporal, masseter) regions revealed also greater scores (p<0.05) in the Headache-group. In the latter the total tenderness score was significantly positively correlated with passive cervical extension (ρ=0.78). Conclusion. Consistent higher tenderness scores suggest involvement of sensitization in patients with episodic cervical headache. A positive correlation was seen between passive cervical extension and sensitivity.