Contribution of Myofascialnext term Trigger Points to Migraine Symptoms - Chiropractic Treatment

Contribution of Myofascialnext term Trigger Points to Migraine Symptoms
November 2007
Maria Adele GiamberardinoCorresponding Author Contact Information, a, E-mail The Corresponding Author, Emmanuele Tafuria, Antonella Savinia, Alessandra Fabrizioa, Giannapia Affaitatia, Rosanna Lerzaa, Livio Di Iannia, Domenico Lapennaa and Andrea Mezzettia
aHeadache Center, Department of Medicine and Science of Aging, ÏG. DÌAnnunzioÓ University; Ce.S.I., ÏG. DÌAnnunzioÓ Foundation, Chieti, Italy.
The Journal of Pain

This study evaluated the contribution of previous termmyofascialnext term trigger points (TrPs) to migraine pain. Seventy-eight migraine patients with cervical active TrPs whose referred areas (RAs) coincided with migraine sites (frontal/temporal) underwent electrical pain threshold measurement in skin, subcutis, and muscle in TrPs and RAs at baseline and after 3, 10, 30, and 60 days; migraine pain assessment (number and intensity of attacks) for 60 days before and 60 days after study start. Fifty-four patients (group 1) underwent TrP anesthetic infiltration on the 3rd, 10th, 30th, and 60th day (after threshold measurement); 24 (group 2) received no treatment. Twenty normal subjects underwent threshold measurements in the same sites and time points as patients. At baseline, all patients showed lower than normal thresholds in TrPs and RAs in all tissues (P < .001). During treatment in group 1, all thresholds increased progressively in TrPs and RAs (P < .0001), with sensory normalization of skin/subcutis in RAs at the end of treatment; migraine pain decreased (P < .001). Threshold increase in RAs and migraine reduction correlated linearly (.0001 < P < .006). In group 2 and normal subjects, no changes occurred. Cervical TrPs with referred areas in migraine sites thus contribute substantially to migraine symptoms, the peripheral nociceptive input from TrPs probably enhancing the sensitization level of central sensory neurons.

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