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Occipitalis Trigger Points - Dr. Jonathan Kuttner


Long-term inputs from trigger points may lead to a vicious cycle that converts periodic headaches into chronic tension headaches.

Muscular problems and tension are commonly associated with TTH, and trigger points within muscles may either be causative or may perpetuate TTH.

The most commonly affected muscles are trapezius, sternocleidomastoid, temporalis, masseter and occipitofrontalis. 

The pain processing part of the central nervous system is almost certainly involved in TTH as it shows up abnormal in scans.

Trigger points often add to the misery of headaches because they are associated with peripheral and central sensitization.

Long-term inputs from trigger points may lead to a vicious cycle that converts periodic headaches into chronic tension headaches.

In such cases even if the original initiating factor is eliminated, the trigger point-central sensitization cycle can perpetuate or even worsen.

TTH are often aggravated by stress, anxiety, depression, fatigue, noise, and glare, but they can also be associated with neck arthritis or a neck disc problem.





Most Common Causes of TTH

• Stress usually occurs in the afternoon following long stressful work hours or after an exam

• Sleep deprivation

• Uncomfortable stressful position and/or bad posture

• Irregular meal time (hunger is reported in up to 50% of TTH sufferers)

• Eyestrain

• Tooth clenching (bruxism)

• Postural issues

Acute or Chronic

TTH headaches can be episodic or chronic. Episodic tension-type headaches are defined as tension-type headaches occurring fewer than 15 days a month, whereas chronic tension headaches occur 15 days or more a month for at least 6 months.

Headaches can last from minutes to days, months or even years, though a typical tension headache lasts 4–6 hours.


Trigger Point Therapy for Headaches


TTH fact file - (Vernon H, 2009)

1. The most prevalent form of benign primary headache with a reported prevalence varying from 65-90%, depending on the classification, description, and severity of headache features.

2. The psychosocial impacts of TTH include disruptions of daily activities, quality of life & work and are accompanied by considerable costs.

3. The International Headache Society (IHS) characterizes TTH as bilateral headaches of mild-to-moderate intensity that are experienced with an aching, tightening, or pressing quality of pain.

4. Headaches may last from 30 minutes to 7 days, are not accompanied by nausea or vomiting, and may have light sensitivity (photophobia) or sound sensitivity (phonophobia) but not both.

5. Headache frequency is classified as ‘episodic’ (<15 headaches per month) or ‘chronic’ (>15 per month).

6. Episodic TTH is by far the more prevalent category.

7. The chronic TTH patient has a higher frequency of both active and latent triggers points in the suboccipital muscles.

8. The chronic TTH patient with active trigger points may have a greater headache intensity and frequency and forward head posture than those with latent trigger points.












This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. 




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