Investigation of the Strength and Thickness of Upper Posterior Cervical Muscles in Women with Tension Headache

Introduction: In the etiology of tension type headache, the weakness of the upper posterior cervical muscles is associated to myofascial pain in cranio-cervical area. The aim of this study was to compare the strength and the thickness of the upper posterior neck muscles in women with chronic tension type headache and healthy control. Materials and methods: The strength and the thickness of upper posterior neck muscles were measured in 33 women (16 women with chronic tension type headache and 16 healthy controls). The strength of the upper cervical extensor muscles and the thickness of semispinalis capitis, splenius capitis, rectus capitis posterior major and oblique capitis superior muscles were measured by a custom made isometric device and a real-time ultrasonography machine. Pain was assessed by a visual analogue scale. Results: The strength of the muscles was significantly lower in patients with chronic tension type headache than the control group (P<0.001). Only, the thicknesses of rectus capitis posterior major and oblique capitis superior muscles were significantly smaller in patients compare to the healthy controls (P<0.001). A statistical negative correlation had been found between the levels of pain and the strength of upper posterior neck muscles (r=-0.65, P=0.006). Conclusion: The results have indicated that rectus posterior major and oblique capitis superior muscles may be weaker in patients with chronic tension type headache than controls. The results may be useful when evaluating the patients with chronic tension type headache by means of the level of upper cervical muscle strength and the muscle thickness measurements.Keywords: Strength, Thickness, Tension Chronic Headache, Upper Posterior Neck Muscle