Background: Most non-pharmacological interventions for tension-type headache (TTH) focus on direct intervention in areas associated with headaches, with limited research exploring the indirect effects of interventions utilizing the fascia. Objectives: To investigate the effects of superficial back line (SBL) stretching and head-neck massage interventions on the range of motion (ROM) and neck disability index (NDI) of TTH. Design: Randomized controlled trial. Methods: The study participants were randomly allocated into three groups: SBL stretching group (n=9), head-neck massage group (n=9), and combined group (n=9). Prior to the intervention, measurements were taken for neck flexion ROM, straight leg raising test (SLRT) ROM, and NDI. The intervention consisted of 30-minute sessions conducted twice a week for 8 weeks. The second measurement took place 4 weeks after the intervention, followed by a third measurement conducted after an additional 4 weeks of intervention. Results: Comparing neck flexion ROM within each group, a significant increase was observed in the SBL stretching group after 8 weeks compared to before the intervention (P<.05). Regarding the comparison of SLRT ROM within each group, a significant increase was noted after 8 weeks compared to before the intervention in the SBL stretching, head-neck massage, and combined groups (P<.05). In terms of the comparison of NDI within each group, a significant decrease was observed in all three group after the intervention compared to before the intervention (P<.05). Conclusion: 8-week intervention involving SBL stretching, head-neck massage, and their combined application demonstrated effectiveness in improving neck flexion ROM, SLRT ROM, and the NDI for individuals with TTH.

Background: The muscles associated with tension-type headache (TTH) are connected to the scalp fascia, which is firmly attached to the superciliary ridge of the frontal bone. However, there is a paucity of data on treatments for TTH that directly target the scalp fasciae. Objectives: We aimed to validate a new manual therapy to treat TTH by applying myofascial relaxation techniques to the scalp and to examine the changes in quality of life and headache characteristics after treatment. Design: pretest-posttest control group design study. Methods: Total 24 participants with TTH (10 males, 14 females) participated in the study. Manual therapy group (MT) received standard manual therapy and scalp myofascial release technique group (SMT) received scalp myofascial release technique twice per week for 4 weeks. Brief Pain Inventory (BPI) and Headache Impact Test (HIT) for quality of life, headache frequency, duration, and Visual Analog Scale (VAS) for intensity were assessed at the pre- and post-treatment. Results: There was a significant improvement within groups in headache frequency (MT P<.05, SMT P<.001), duration (MT P<.05, SMT P<.01), VAS (MT P<.01, SMT P<.001), HIT (MT P<.001, SMT P<.001), and BPI (MT P<.001, SMT P<.001) between the pre- and post-treatment. Group differences were significant for headache duration (P=.027), but the others were not. MT and SMT reduced the impact of headaches on daily life. Also Headache frequency, duration, intensity, and BPI were improved. Conclusion: MT and SMT reduced the impact of headaches on daily life. Also Headache frequency, duration, intensity, and BPI were improved. It has been suggested that both MT and SMT can be used as a non-invasive treatment to treat the TTH, and to improve the quality of life.

Background:Active trigger points (TrPs) of the suboccipital muscles greatly contribute to the occurrence of chronic tension-type headache, with increased sensitivity of TrPs and facilitated referred pain.Objects:This study aimed to investigate whether the integration of high-frequency diathermy into suboccipital release is more beneficial than the use of suboccipital release alone.Methods:Thirty subjects were assigned to either experimental group-1 (EG-1) to undergo suboccipital release combined with high-frequency diathermy (frequency: 0.3 MHz, and electrode type: resistive electronic transfer), or EG-2 to undergo suboccipital release alone, or the control group (CG) with no intervention, with 10 subjects in each group. The assessment tools included the headache impact test 6 (HIT-6), perceived level of tenderness, neck disability index, and neck mobility. Intervention was performed for 10 minutes, twice per week, for 4 weeks, and measurements were performed before and after the interventions.Results:The between-group comparison of the post-test values and changes between pretest and post-test showed significant differences for all parameters at p<.05, except for the left-to-right lateral bending range. In the post hoc test, EG-1 showed significant differences for the parameters in comparison with the CG, while no significant differences in the perceived tenderness level, on both temporal regions, were found between EG-2 and CG. Furthermore, the HIT-6 score and perceived tenderness level, in the right temporal region, showed significant differences between EG-1 and EG-2. In the within-group comparison, EG-1 and EG-2 appeared to be significantly different between pretest and post-test (p<.05), except for the perceived tenderness level in the right temporal region, with significance for the EG-1 group only (p<.05).Conclusion:These findings suggest that the suboccipital release technique may be advantageous to improve headache, tenderness, and neck function and mobility, with more favorable effects with the incorporation of high-frequency diathermy.