Women with vs without frequent episodic tension-type headache (TTH) may have greater nerve sensitivity in response to mechanical stimuli, according to a study in Musculoskeletal Science and Practice.
In this case-control, cross-sectional analysis, 32 consecutive women with TTH and 32 age-matched control individuals without a history of headache over the previous year were recruited from a university center in Spain. Participants were asked to complete a headache diary for 4 weeks and to assess headache intensity using an 11-point numeric pain rating scale (NPRS). They also underwent mechanical provocation tests of the nerve tissues using the Passive Straight-Leg Raise Test (SLR), Long Sitting Slump test, and Seated Slump test (SLT). The SLR and SLT are used to assess sensitivity of the lumbosacral nerve roots and mechanical sensitivity of the nervous tissue, respectively.
Women with frequent episodic TTH were found to have lower bilateral flexion with 30° plantar flexion and neutral ankle position compared with controls in the passive SLR test (P <.001), but not between sides.
In the Long Sitting Slump test, women with frequent episodic TTH had reduced cervical flexion (P <.001) and a greater intensity of sensory response (P <.001) compared with healthy controls. Women with vs without frequent episodic TTH also had a lower bilateral knee extension range of motion (P <.001) and greater pain intensity responses (P <.001), as indicated by the SLT.
Study limitations include the small sample size, the sole inclusion of women, and the recruitment of patients from a single center.
“These findings suggest the presence of heightened nerve mechanical sensitivity in women with frequent episodic TTH, which may drive the sensitization processes in this population,” concluded the study authors.
Caamaño-Barrios LH, Galán-Del-Río F, Fernández-de-Las-Peñas C, Cleland JA, Plaza-Manzano G, Ortega-Santiago R. Evaluation of neurodynamic responses in women with frequent episodic tension type headache. Musculoskelet Sci Pract. 2019;44:102063.