Tension-Type Headache Clinical Trial
Official title:
Bite Force and Muscle Function in Patients With Tension-type Headache
Patients with tension-type headache (TTH) and migraine often experience musculoskeletal
complaints, like neck pain and/or jaw pain. Earlier studies have revealed an association
between different headache types and neck pain and discussed the possible role of the
cervical muscles. Furthermore, patients with neck pain show a decrease in motor control of
the jaw, without having any other signs of TMD. Similarly, studies in patients with TMD have
only found an indication for poorer neck muscle function. Patients with TMD also show a
decrease in bite force and force steadiness compared to healthy controls. It is however,
unknown if bite force and force steadiness are similarly impaired in patients with headache
and/or neck pain.
The current study will take a closer look at the jaw muscle function of in patients with TTH,
with and without neck pain.
Tension-type headache (TTH) and migraine has been found to coincide with cervical pain,
musculoskeletal dysfunction and/or temporomandibular disorders (TMD). The possible interplay
between these three symptoms/disorders, headache, neck pain and TMD, have not been studied
completely, only in sections. Earlier studies have revealed an association between different
headache types and neck pain and discussed the possible role of the cervical muscles.
Patients with TTH and (chronic) migraine exhibit lower muscle strength in the neck extensor
muscles compared to healthy controls. Patients with neck pain show a decrease in motor
control of the jaw, without having any other signs of TMD. Similarly, studies in patients
with TMD have only found an indication for poorer neck muscle function while patients with
TMD also show a decrease in bite force and force steadiness compared to healthy controls. It
is however, unknown if bite force and force steadiness are similarly impaired in patients
with headache and/or neck pain.
Muscle tenderness increases with increasing headache frequency and intensity in TTH while
this association is not present in migraine patients. Tenderness has a significant influence
on the neck muscle function in TTH patients and there is a negative correlation between Total
Tenderness (TTS) and muscle force. There is currently, however, no clear understanding of the
influence of tenderness on the function of jaw muscles in TTH patients.
The current project will increase the investigator's understanding of the interplay or
dependency between the function of the jaw and neck muscles in TTH patients. If a comorbidity
of TMD or neck pain make TTH patients more prone to dysfunction of jaw and neck muscles, this
may lead to a subgrouping of these TTH patients. Together with the muscle function deficits
discovered in the current case control study, this may suggest a targeted treatment for TTH
to be tested in a follow up randomized control study.
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