Objectives: The purpose of this study was to compare pericranial tenderness of females with episodic cervical headache vs matched asymptomatic controls.

Methods: Through a single-blind, cross-sectional study, pericranial tenderness was compared between 20 females with episodic cervical headaches (29.4 ± 13.2 years) and 20 age-matched female asymptomatic controls (30.1 ± 13.7 years). Pericranial tenderness was bilaterally measured in a headache-free period with the “total tenderness score” (TTS) in the suboccipital, temporal, frontal, masseter, upper trapezius (UT), levator scapula, and sternocleidomastoid (SCM) 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 passive cervical mobility and headache characteristics and the TTS were estimated with Spearman’s ρ.

Results: The headache group (1.25 ± 0.89) showed a 2 times higher (P < .05) pericranial TTS compared to the control group (0.62 ± 0.70). Higher (P < .05) scores were observed for the left suboccipital, temporal, masseter, UT, levator scapula, and SCM muscles and the right suboccipital, frontal, UT, and levator scapula muscles. Grouping the tenderness scores into cervical (suboccipital, UT, levator scapula, SCM) and cephalic (frontal, temporal, masseter) regions revealed greater scores (P < .05) in the headache group. In the latter, the TTS was significantly positively correlated with passive cervical extension (ρ = 0.78).

Conclusion: Consistent higher tenderness scores were observed and suggest involvement of sensitization in patients with episodic cervical headaches. A positive correlation was seen between passive cervical extension and sensitivity.

Author keywords: Headache, Posture, Central Nervous System Sensitization, Pain Threshold, Neck

Author affiliations: Faculty Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium

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