Diseases secondary to trigger points and myofascial...
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Diseases that are secondary to trigger points and myofascial pain syndrome such as tension-type headache and trigger-point-related migraine

Tension-type headache (TTH) is characterized by a bilateral, pressing, tightening pain of mild to moderate intensity, and is the most featureless of the primary headaches. TTH can occur in short episodes of variable duration (episodic forms) or continuously (chronic form). Infrequent Episodic TTH (< 1 day of headache per month) usually does not require medical treatment except with simple analgesics. In contrast, both patients with Frequent Episodic TTH (ETTH; between 12 and 180 days of headache per year) and Chronic TTH (CTTH; at least 189 days of headache per year) may encounter considerable disability and warrant specific intervention. The lifetime prevalence of TTH is approximately 78%, with 24% to 37% of patients suffering from TTH several times a month, 10% weekly and 2% to 3% of the population suffering from CTTH lasting usually for the greater part of a lifetime. Because many secondary headaches may mimic TTH, a diagnosis of TTH requires exclusion of other organic diseases. In most patients, TTH develops from the episodic form to the chronic form, and prolonged peripheral nociceptive stimuli from pericranial myofascial tissues seem to be responsible for the conversion of ETTH to CTTH. TTH is considered the prototype of headaches in which myofascial pain plays an important role. Many studies have reported an increased number of active and latent myofascial trigger points in pericranial muscles in patients with ETTH and CTTH. These active and latent myofascial trigger points can be found in the suboccipital, splenius capitis, splenius cervicis, semispinalis capitis, semispinalis cervicis, levator scapulae and upper trapezius muscles. Short-term relief of headache by myofascial trigger points release has been successfully demonstrated in CTTH.

Both ETTH and CTTH can be treated with radial shock wave therapy (RSWT^®) when focusing on the treatment of active and latent myofascial trigger points in the suboccipital, splenius capitis, splenius cervicis, semispinalis capitis, semispinalis cervicis, levator scapulae and upper trapezius muscles.

Episodic migraine is defined as less than eight days per month with headache having the features of migraine headache. In contrast, headache on at least 15 days per months for more than three months, with headache having the features of migraine headache on at least eight days per month, is defined as chronic migraine (CM). The prevalence of CM is approximately 1-2%. Several studies suggest that musculoskeletal dysfunction of the neck is a contributing factor to the etiology of migraine. Specifically, myofascial trigger points (MFTPs) are considered a trigger factor that can facilitate the onset of migraine. Furthermore, MFTPs may promote pain once a migraine attack has started and thus, may contribute to disability in migraine. Radial shock wave therapy (RSWT^®) is very effective in releasing MFTPs.