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Old 03-24-2007, 03:00 PM #1
painfree painfree is offline
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Default Headaches and Myofascial Trigger Points

Headaches and a common overlooked source of them are often the result of Myofascial Trigger Points. These muscle knots that cause headaches are usually located in the neck and upper back, but can be the result of trigger points in other parts of the body beginning at the foot.

The trigger point is a hyper-irritable focus within the muscle or fascia that causes taut bands and characteristic, predictable, referred pain like that seen in the neck muscles. Trigger point referred pain does not follow typical dermatome patterns.
Trigger points cause the muscle to become shorter and tighter. This limits the function and mobility of the muscle which causes weakness, decreased circulation and pain. When injured, most tissues heal, but muscles learn they learn to avoid pain. This muscle memory can produce unexpected pain years after an injury has occurred, especially during times of physical and emotional stress.

Trigger Point overview Myofascial Trigger Point Therapy is a therapeutic discipline and technique used for the relief of myofascial (myo=muscle; fascial=connective tissue) pain and dysfunction. It is a modality resulting from the lifelong medical careers of Drs. Janet Travell and David Simons. Myofascial Trigger Point Therapy is recognized by the American Academy of Pain Management as a modality for the treatment of myofascial pain and dysfunction.

The probability of success in treating Migraine headaches as the result of Myofascial Trigger Pointss (TrP) with and without aura is high.

Trigger point therapy for headache secondary to paroxysmal hemicrania, unassociated structural lesion, vascular disorders, nonvascular intracranial disorders, substance withdraw, noncephalic infection, metabolic disorder and cranial neuralgia is low to moderate.

For example, Headache pain behind the eye can come from an active myofascial trigger point in your upper spenius cervicis muscle(s) located in the back of your neck.
The pain from this muscle is projected upward to the occipt, diffusely through the cranium, and intensely to the back of the orbit (eye) - "an ache inside the skull." Sometimes splenius cervics pain is referred downward to the shoulder girdle and to the angle of the neck.
The functions of these splenii include working together to extend the head and neck and individually rotate the head and neck, turning the face toward the same side.

Symptoms of headache and or neck pain with homolateral blurring of vision can be the can be due to active trigger points in the spenius cervicis and splenius capitis muscles.

The activation and perpetuation of trigger points in these muscles are often due to sudden overload, such as whiplash, or caused by prolonged holding the head and neck in a forward, crooked position for a prolonged time, like playing the violin for a living. These neck muscles are especially vulnerable when they are tires and the overlying skin is exposed to a cold draft.


Another common cause of severe headaches are Trigger points in the Sternocleidomastoid Muscle(S) or knots in the muscles in the front to side of you neck. There are two divisions the sternal and clavicular.
Trigger points in each division can evoke referred pain, autonomic phenomena or proprioceptive disturbances.

Pain can be felt above the eyes (optical migraine), in ear, cheeks, to the throat, back and top of the head.

Autonomic phenomena from the sternal division involve the eye and sinuses, while the clavicular division are more likely to concern the forehead (sweating of the forehead on the same side) and ear (vertigo), including dizziness related to disturbed proprioception and spatial perception. These symptoms seem to match a large portion of the posted problems with the headache and vision and reoccurring droopy eye.
Dr.’s may diagnose this as atypical facial neuralgia.

The motor nerve fibers of the sternocleidomastoid muscle have an unusually close association with the brain stem. They pass through the cervical portion of the cranial nerve XI (accessory nerve). These motor fibers of the cervical portion arise within the spinal column from the ventral roots (motor fibers) of the upper five cervical segments and ascend, entering the skull through the foramen magnum to join the cranial portion
of the accessory nerve. Together, they exit the skull in close association with the vegas nerve through the jugular foramen.

Trigger Point therapy may help resolve headache symptoms and function.



When a trigger point is located, a slow sustained pressure is applied. Initially, the trigger point may be very tender, but pain gradually decreases and fades as the muscle begins to relax. The referred pain will decrease and a specific stretch of the muscle will be done. This process of trigger point release and stretch decreases pain and restores normal functioning.

Once the trigger points are resolved in those muscle groups the pain is usually reduced significantly.

You may want to research this type of pain and dysfunction. You may have access through your medical library to the Travell & Simons’ Myofascial Pain and Dysfunction Trigger Point Manual Volume 1: Upper Half of the body and Volume 2: The Lower Extremities

Round Earth Publishing has some great information on this subject, take a look at: http://www.round-earth.com/HeadPainIntro.html
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Old 03-28-2007, 07:36 AM #2
momzpeachy momzpeachy is offline
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Default my experience

I have been recently diagnosed with myofascial thoracic outlet syndrome. Almost a year ago my symptoms started out as headaches with some fatigue and achiness in the right arm. I also felt like I was losing some muscle strength. I went to the neurologist who seemed to only be concerned about the headaches. I went for an MRI, and EEG and catscan. Everything came back negative and the Doctor couldn't find any reason for the headaches. He prescribed me some medicine for the headaces (which I didn't take) and then never saw me again.

Well over time while doing repetitive work I got much worse and didn't even realize that what I was doing at work and how I was sitting caused the mess I'm in.

I really wish more Doctor's would listen to us who have certain symptoms and look more into things. I probably wouldn't be in this severe pain I'm in if the Doctor would've looked harder last year and found what was really going on. A lot could'vebeen prevented. I had no idea that my job was gonna get me in this mess and PAIN!

I have severe pain which a lot of trigger points. My muscles are so abnormal that ehy jump so bad every time I see the Doc. I've been going through injection now for 4 weeks and still having severe pain and tightness. The injections of lidocaine do work but what a process.

If anyone is experiencing headaches along with other symptoms...you should insist that the Doctor looks harder. TOS is a serious thing and I think it gets overlooked by many.

I still have headaches every day along with severe right arm pain, neck pain, trouble swallowing, coughing, ear pain, jaw pain, can't lift anything, etc...etc...

I just wish it could've been somewhat prevented. I also wish employers knew how important ERGONOMICS is!
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momz of NE PA:
Right side TOS (Scalenectomy 1-14-08). Spinal problems. Thoracic Spine hernaited discs pressing on spinal cord and small tumor - still being investigated. A very tired mom who feels like giving up!

Wishing I could think more positive and be well again!
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Old 06-02-2007, 06:12 PM #3
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Originally Posted by momzpeachy View Post
...I still have headaches every day along with severe right arm pain, neck pain, trouble swallowing, coughing, ear pain, jaw pain, can't lift anything, etc...etc...

I just wish it could've been somewhat prevented. I also wish employers knew how important ERGONOMICS is!
I have two pain sources: my RA and the OTHER stuff which I have been told is everything from cervical stenosis to possible MS to post surgical radiculapathy to TOS to fibromyalgia to Arnold Chiari malformation to myfascial pain syndrome...sigh...everyone reads the MRIs differently it seems.

When I attempt to lie down...I get an instant occipital headache with arm and shoulder pain. Last neurosurg and pain management docs I saw said it was a post surgical result. Prior to surgery on cervical spine, I only had the occipital headaches upon reclining!

Falling asleep and staying asleep is ALWAYS a challenge.

Gentle ehugs, Carly
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Advanced Glaucoma~RA/secondary fibromyalgia~Cervical Radiculapathy post ACDF 5-6~TOS

"What do we live for if it is not to make life less difficult for each other." ~ George Eliot
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