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Jaw Muscle Function in Patients With Tension-type Headache

Conditions
Tension-Type Headache
Headache Disorders
Interventions
Other: Bite force testing
Registration Number
NCT04196127
Lead Sponsor
Danish Headache Center
Brief Summary

Patients with tension-type headache (TTH) and migraine often experience musculoskeletal complaints, like neck pain and/or jaw pain. Earlier studies have revealed an association between different headache types and neck pain and discussed the possible role of the cervical muscles. Furthermore, patients with neck pain show a decrease in motor control of the jaw, without having any other signs of TMD. Similarly, studies in patients with TMD have only found an indication for poorer neck muscle function. Patients with TMD also show a decrease in bite force and force steadiness compared to healthy controls. It is however, unknown if bite force and force steadiness are similarly impaired in patients with headache and/or neck pain.

The current study will take a closer look at the jaw muscle function of in patients with TTH, with and without neck pain.

Detailed Description

Tension-type headache (TTH) and migraine has been found to coincide with cervical pain, musculoskeletal dysfunction and/or temporomandibular disorders (TMD). The possible interplay between these three symptoms/disorders, headache, neck pain and TMD, have not been studied completely, only in sections. Earlier studies have revealed an association between different headache types and neck pain and discussed the possible role of the cervical muscles. Patients with TTH and (chronic) migraine exhibit lower muscle strength in the neck extensor muscles compared to healthy controls. Patients with neck pain show a decrease in motor control of the jaw, without having any other signs of TMD. Similarly, studies in patients with TMD have only found an indication for poorer neck muscle function while patients with TMD also show a decrease in bite force and force steadiness compared to healthy controls. It is however, unknown if bite force and force steadiness are similarly impaired in patients with headache and/or neck pain.

Muscle tenderness increases with increasing headache frequency and intensity in TTH while this association is not present in migraine patients. Tenderness has a significant influence on the neck muscle function in TTH patients and there is a negative correlation between Total Tenderness (TTS) and muscle force. There is currently, however, no clear understanding of the influence of tenderness on the function of jaw muscles in TTH patients.

The current project will increase the investigator's understanding of the interplay or dependency between the function of the jaw and neck muscles in TTH patients. If a comorbidity of TMD or neck pain make TTH patients more prone to dysfunction of jaw and neck muscles, this may lead to a subgrouping of these TTH patients. Together with the muscle function deficits discovered in the current case control study, this may suggest a targeted treatment for TTH to be tested in a follow up randomized control study.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Age between 18 and 55 years old.
  • Diagnosed Frequent episodic TTH (1-14 headache days / month) or chronic TTH (≥15 headache days/ month) based on the ICHD-3.
  • Maximum 3 days of migraine per month.
  • Signed informed acceptance of participation.
Exclusion Criteria
  • medication overuse headache (ICHD-3)
  • missing more than 1 molar,
  • previous whiplash or head trauma,
  • other major physical or neurological diseases,
  • diagnosed depression, other mental illness
  • unable to understand and speak Danish.
  • Pregnant or lactating women.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
TTHBite force testingPatients with tension-type headache. They may not experience migraine, but can experience neck pain and/or temporomandibular dysfunction.
Healthy controlsBite force testingParticipants without frequent headaches. They may experience neck pain and/or temporomandibular dysfunction.
Primary Outcome Measures
NameTimeMethod
Maximum Bite Forcebaseline

Maximum bite force in Newton, best out of three tests

Secondary Outcome Measures
NameTimeMethod
Total Tenderness ScoreImmediately after muscle function testing (outcomes 1-3)

Overall total tenderness score (range 0 - 48; higher score means higher tenderness of the muscles).

Bite Force Steadinessbaseline

30% of maximum bite force held for 30 seconds, expressed as mean and standard deviation

Neck muscle functionbaseline

Ratio of flexion/extension strength

Trial Locations

Locations (1)

Danish Headache Center Rigshospitalet - Glostrup

🇩🇰

Glostrup, Denmark

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