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. 2010 May 28;11(5):399–404. doi: 10.1007/s10194-010-0224-1

Restricted neck mobility in children with chronic tension type headache: a blinded, controlled study

Daniel M Fernández-Mayoralas 1,2, César Fernández-de-las-Peñas 3,4,5,9,✉, Domingo Palacios-Ceña 6, Irene Cantarero-Villanueva 7, Carolina Fernández-Lao 7, Juan A Pareja 1,8
PMCID: PMC3452272  PMID: 20508963

Abstract

The main purpose of this study was to analyze the differences in neck mobility between children with chronic tension type headache (CTTH) and healthy children, and to determine the influence of cervical mobility on headache intensity, frequency and duration. Fifty children, 13 boys and 37 girls (mean age 8.5 ± 1.6 years) with CTTH associated to peri-cranial tenderness (IHS 2.3.1) and 50 age- and sex matched children without headache (13 boys, 37 girls, mean age 8.5 ± 1.8 years, P = 0.955) participated. Cervical range of motion (CROM) was objectively assessed with a cervical goniometer by an assessor blinded to the children’s condition. Children completed a headache diary for 4 weeks to confirm the diagnosis. Children with CTTH showed decreased CROM as compared to children without headache for flexion (z = −6.170; P < 0.001), extension (z = −4.230; P < 0.001), right (z = −4.505; P < 0.001) and left (z = −4.768; P < 0.001) lateral-flexions, but not for rotation (right z = −0.802; P = 0.425; left z = −1.254; P = 0.213) and also for total range of motion for flexion-extension (z = −4.267; P < 0.001) and lateral-flexion (z = −4.801; P < 0.001), but not for rotation (z = −1.058; P = 0.293). Within CTTH children, CROM was not correlated with headache intensity, frequency or duration. Additionally, age (P > 0.125) or gender (P > 0.250) did not influence CROM in either children with CTTH or without headache. Current results support the hypothesis that the cervical spine should be explored in children with headache. Further research is also needed to clearly define the potential role of the cervical spine in the genesis or maintenance of CTTH.

Keywords: Tension-type headache, Cervical range of motion, Cervical spine, Children

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Conflict of interest

None.

References

  • 1.Andlin-Sobocki P, Jonsson B, Wittchen HU, Olesen J. Cost of disorders of the brain in Europe. Eur J Neurol. 2005;12(Suppl 1):1–27. doi: 10.1111/j.1468-1331.2005.01202.x. [DOI] [PubMed] [Google Scholar]
  • 2.Unalp A, Dirik E, Kurul S. Prevalence and clinical findings of migraine and tension-type headache in adolescents. Pediatr Int. 2007;49:943–949. doi: 10.1111/j.1442-200X.2007.02484.x. [DOI] [PubMed] [Google Scholar]
  • 3.Ayatollahi SM, Khosravi A. Prevalence of migraine and tension-type headache in primary-school children in Shiraz. East Mediterr Health J. 2006;12:809–817. [PubMed] [Google Scholar]
  • 4.Laurell K, Larsson B, Eeg-Olofsson O. Prevalence of headache in Swedish school-children, with a focus on tension-type headache. Cephalalgia. 2004;24:380–388. doi: 10.1111/j.1468-2982.2004.00681.x. [DOI] [PubMed] [Google Scholar]
  • 5.Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T. The prevalence of migraine and tension-type headaches among adolescents in Norway: the Nord-Trøndelag Health Study (Head-HUNT-Youth), a population-based epidemiological study. Cephalalgia. 2004;24:373–379. doi: 10.1111/j.1468-2982.2004.00680.x. [DOI] [PubMed] [Google Scholar]
  • 6.Stovner L, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, Steiner T, Zwart JA. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210. doi: 10.1111/j.1468-2982.2007.01288.x. [DOI] [PubMed] [Google Scholar]
  • 7.Fernández-de-las-Peñas C, Schoenen J. Chronic tension type headache: what’s new? Curr Opin Neurol. 2009;22:254–261. doi: 10.1097/WCO.0b013e32832973ce. [DOI] [PubMed] [Google Scholar]
  • 8.Anttila P, Metsahonkala L, Mikkelsson M, et al. Muscle tenderness in pericranial and neck-shoulder region in children with headache: a controlled study. Cephalalgia. 2002;22:340–344. doi: 10.1046/j.1468-2982.2002.00352.x. [DOI] [PubMed] [Google Scholar]
  • 9.Metsahonkala L, Anttila P, Laimi K, et al. Extra-cephalic tenderness and pressure pain threshold in children with headache. Eur J Pain. 2006;10:581–585. doi: 10.1016/j.ejpain.2005.08.005. [DOI] [PubMed] [Google Scholar]
  • 10.Laimi K, Vahlberg T, Salminen J, Metsähonkala L, Mikkelsson M, Anttila P, Aromaa M, Sillanpää M. Does neck pain determine the outcome of adolescent headache? Cephalalgia. 2007;27:244–253. doi: 10.1111/j.1468-2982.2006.01266.x. [DOI] [PubMed] [Google Scholar]
  • 11.Laimi K, Salminen JJ, Metsähonkala L, Vahlberg T, Mikkelsson M, Anttila P, Aromaa M, Rautava P, Suominen S, Liljeström MR, Sillanpää M. Characteristics of neck pain associated with adolescent headache. Cephalalgia. 2007;27:1244–1254. doi: 10.1111/j.1468-2982.2007.01439.x. [DOI] [PubMed] [Google Scholar]
  • 12.Jull G, Amiri M, Bullock-Saxton J, Darnell R, Lander C. Cervical musculoskeletal impairment in frequent intermittent headache––part 1: subjects with single headaches. Cephalalgia. 2007;27:793–802. doi: 10.1111/j.1468-2982.2007.01345.x. [DOI] [PubMed] [Google Scholar]
  • 13.Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Manual Ther. 2006;11:118–129. doi: 10.1016/j.math.2005.04.007. [DOI] [PubMed] [Google Scholar]
  • 14.Fernández-de-las-Peñas C, Alonso Blanco C, Cuadrado ML, Pareja JA. Forward head posture and neck mobility in chronic tension type headache: a blinded, controlled study. Cephalalgia. 2006;26:314–319. doi: 10.1111/j.1468-2982.2005.01042.x. [DOI] [PubMed] [Google Scholar]
  • 15.Fernández-de-las-Peñas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck mobility and forward head posture in unilateral migraine. Cephalalgia. 2006;26:1061–1070. doi: 10.1111/j.1468-2982.2006.01162.x. [DOI] [PubMed] [Google Scholar]
  • 16.Oksanen A, Metsähonkala L, Viander S, Jäppilä E, Aromaa M, Anttila P, Salminen J, Sillanpää M. Strength and mobility of the neck-shoulder region in adolescent headache. Physiother Theory Pract. 2006;22:163–174. doi: 10.1080/09593980600822800. [DOI] [PubMed] [Google Scholar]
  • 17.IHS: Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders, 2nd edn Cephalalgia 24 (suppl 1):9–160 [DOI] [PubMed]
  • 18.Langemark M, Olesen J. Pericranial tenderness in tension headache: a blind controlled study. Cephalalgia. 1987;7:245–249. doi: 10.1046/j.1468-2982.1987.0704249.x. [DOI] [PubMed] [Google Scholar]
  • 19.Phillip D, Lyngberg AC, Jensen R. Assessment of headache diagnosis: a comparative population study of a clinical interview with a diagnostic headache diary. Cephalalgia. 2007;27:1–8. doi: 10.1111/j.1468-2982.2007.01239.x. [DOI] [PubMed] [Google Scholar]
  • 20.Jensen MP, Turner JA, Romano JM, Fisher L. Comparative reliability and validity of chronic pain intensity measures. Pain. 1999;83:157–162. doi: 10.1016/S0304-3959(99)00101-3. [DOI] [PubMed] [Google Scholar]
  • 21.Beck AT, Steer RA, Brown GK (1996) Beck depression inventory. 2nd edn, The Psychological Corporation. San Antonio
  • 22.Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev. 1988;8:77–100. doi: 10.1016/0272-7358(88)90050-5. [DOI] [Google Scholar]
  • 23.VanVoorhis WCR, Blumentritt TL (2007) Psychometric properties of the beck depression inventory-II in a clinically-identified sample of Mexican American Adolescents. J Child Family Studies, pp 789–798
  • 24.Fletcher JP, Bandy WD. Intrarater reliability of CROM measurement of cervical spine active range of motion in persons with and without neck pain. J Orthop Sports Phys Ther. 2008;38:640–645. doi: 10.2519/jospt.2008.2680. [DOI] [PubMed] [Google Scholar]
  • 25.Chen J, Solinger AB, Poncet JF, Lantz CA. Meta-analysis of normative cervical motion. Spine. 1999;24:1571–1578. doi: 10.1097/00007632-199908010-00011. [DOI] [PubMed] [Google Scholar]
  • 26.Netzer O, Paine VG. Effects of age and gender on functional rotation and lateral movements of the neck and back. Gerontology. 1993;39:320–326. doi: 10.1159/000213549. [DOI] [PubMed] [Google Scholar]
  • 27.Dvorak J, Antinnes JA, Panjabi M, Loustalot D, Bonomo M. Age and gender related normal motion of the cervical spine. Spine. 1992;17(suppl 10):S393–S398. doi: 10.1097/00007632-199210001-00009. [DOI] [PubMed] [Google Scholar]
  • 28.Mørch CD, Hu J, Arendt-Nielsen L, Sessle B. Convergence of cutaneous, musculo-skeletal, dural and visceral afferents onto nociceptive neurons in the first cervical dorsal horn. Eur J Neuroscience. 2009;26:142–154. doi: 10.1111/j.1460-9568.2007.05608.x. [DOI] [PubMed] [Google Scholar]

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