Efficacy of Trigger Points Self-Massage in Chronic Tension-Type Headache

An Unmasked, Randomized, Non-inferiority Trial

Abstract

Aims: Chronic Tension-Type Headache (CTTH) is a disabling disorder can cause considerable pain and negative impact on the individual health. The present study tended to show trigger point self-massage is not inferior to standard drug treatment in patients with CTTH.

Methods: This was a randomized, unmasked, controlled study with active comparator, on CTTH patients. Eighty participants were randomized to intervention or comparator group. Participants in comparison group received tablet Nortriptyline 10 mg daily and participants in intervention group treated with trigger point self-massage in 8 different points 3 times a day for 4 weeks. Intensity, frequency, duration of headaches and number of analgesic drugs recorded in a diary during week 1 and week 4. Minimal clinical important difference according to IHS guide line considered 30 % decrease in headache index.

Results: Headache index reduced from 92.53±50.98 to 37.73±27.13 in nortriptyline and from 81.60±33.97 to 45.32±24.75 in massage group (p:0.04,f:4.31). Headache intensity reduced from 5.37±1.66 to3.37±1.44  in nortriptyline and from 5.00±1.98 to3.81±1.31 in massage group(p:0.03,f:4.5). Headache duration reduced from16.88±11.43 to 10.12±11.43in nortriptyline and from 15.83±5.83to 11.87±5.50 in massage group(p:0.04,f:4.07). Headache frequency reduced from 3.42+1.15to2.12±1.15 in nortriptyline and from 3.55+1.03 to 2.22±0.91  in massage group(p:0.9,f:0.01). Number of analgesic consumption reduced from 2.85±1.49 to 1.22±1.27in nortriptyline and from 2.62±1.59 to 0.67±0.72 in massage group (p:0.02,f:5.25).

Conclusion: Trigger point massage is an effective and safe strategy but inferior to nortriptyline for prophylactic treatment of CTTH.