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: Tension-type headaches, which make up the highest proportion of headaches, are prone to develop into chronic tension-type headaches (CTTH). The characteristic of CTTH in patients is that the active myofascial trigger point (ATrP) which causes pain in the muscles of the back of the head is increased, compared to the normal headache and moves the head position forward. Objective: The aim of this study was to investigate the effects of myofascial release (MFR) and posture correction in effectively improving neck function and sleep quality in the symptoms of CTTH patients. Design: Observer-blind study Methods: To reduce ATrP, MFR was applied and exercise was also applied to correct posture. The subjects of this study were 48 individuals randomly divided into three groups; The MFR group using the MFR technique; The MFR with exercise group subject to both the MFR technique and forward head position correction exercises (MFREx), and the control group. MFR and MFREx groups were given the relevant interventions twice a week for four consecutive weeks, and went through the number ATrPs, range of motion (ROM) of neck, Neck Disability Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. A physical therapist, who was fully familiar with the measuring methods of the equipment, was the measurer and not aware of the target's condition was blinded to take measurements only before and after intervention. Results: There was a significant improvement in the ATrP, Neck ROM, NDI and PSQI in the group of patients to whom the MFR technique and MFREx were applied. MFREx was more effective in increasing neck mobility. Conclusions: According to this study, the application of MFR is effective in improving neck movement and sleep quality in chronic tension headache patients.

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.