# Association Between Trapezius Muscle Stiffness and Headache Severity in Patients With Tension‐Type Headache

## TL;DR

This study finds that stiffer trapezius muscles are linked to more severe headaches in people with tension-type headaches.

## Contribution

The study establishes a novel association between trapezius muscle stiffness and headache severity in tension-type headache patients.

## Key findings

- Trapezius muscle stiffness positively correlates with headache severity in TTH patients.
- Weakness and heavy eyelid sensation are significant clinical indicators of headache severity.
- Stress and weather changes are significant predictors of headache severity in TTH patients.

## Abstract

Tension‐type headache (TTH) is one of the most prevalent headache disorders worldwide, yet its underlying pathophysiological mechanisms remain poorly understood. Previous research suggests a potential link between myofascial factors, such as trapezius muscle stiffness, and headache severity. This study investigates the association between upper trapezius muscle stiffness and headache severity in patients with TTH.

We conducted a cross‐sectional analysis of 203 patients diagnosed with TTH, evaluating muscle stiffness using a portable muscle hardness meter and headache severity using the Headache Impact Test‐6 (HIT‐6) and Migraine Disability Assessment Scale (MIDAS). Logistic regression analysis was performed to identify correlations between muscle stiffness and headache severity, adjusting for age, sex, and other clinical variables.

The mean muscle stiffness values were 32.5 ± 5.8 on the left and 31.3 ± 5.6 on the right. HIT‐6 scores positively correlated with muscle stiffness (β = 0.148), chronic TTH (β = 0.304), and age (β = −0.203). Significant clinical symptoms associated with headache severity included weakness (β = 0.154) and a heavy eyelid sensation (β = 0.154). However, shoulder stiffness and neck pain were not significantly associated with headache severity. Triggers such as stress and weather changes were also identified as significant predictors of headache severity.

Increased trapezius muscle stiffness positively correlates with greater headache severity in TTH patients. Weakness and heavy eyelid sensation may serve as important clinical indicators of headache severity, offering potential insights for improved diagnosis and management.

This study examined 203 patients with tension‐type headache (TTH) and found that increased trapezius muscle stiffness is associated with greater headache severity. Muscle stiffness was measured using a portable device, and headache severity was assessed using the HIT‐6 and MIDAS scales. Higher HIT‐6 scores were linked to chronic TTH, greater muscle stiffness, and younger age. Additionally, clinical symptoms like weakness and heavy eyelid sensation, as well as predictors such as weather changes and stress, were associated with more severe headaches. The findings suggest that increased trapezius muscle stiffness is associated with greater headache severity in patients with TTH.