Evaluation of neurodynamic responses in women with frequent episodic tension type headache

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Background: Current theories associated with the cause of tension type headache are mostly focused on muscle tissues. No study has investigated the presence of role of nerve tissues in this population. Objective: Our aim was to examine the responses to different mechanical provocation tests of the nerve tissues in women with tension type headache when compared to healthy women. Design: A case-control cross-sectional study. Methods: Differences in range of motion and sensory responses (intensity and location) during the Passive Straight-Leg Raise Test (SLR), Long Sitting Slump test (LSS) and Seated Slump test (SLT) were assessed in 32 women with frequent episodic tension type headache (FETTH) and 32 age-matched healthy women. Results: Women with FETTH demonstrated bilateral and significantly reduced range of motion in all tests (P < 0.001) and also higher sensory responses in the LSS and SLT (both P < 0.001), but not in the SLR (all P > 0.422), compared to the healthy women. The location of sensory responses was also significantly different for the SLT (P < 0.05). Conclusion: The current study observed generalized lower mechanical pain thresholds to different provocation tests of the nerve tissues in women with FETTH supporting the presence of heightened nerve sensitivity to mechanical stimuli in this population. Future trials should investigate the efficacy of neurodynamic techniques in the clinical evolution of TTH.

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