Cervical musculoskeletal impairments in migraine and tension-type headache and relationship to pain related factors: An updated systematic review and meta-analysis
Abstract
BACKGROUND
An updated systematic review of cervical musculoskeletal dysfunction in migraine and tension-type headache is needed. Influencing factors (pain hypersensitivity with cervical musculoskeletal testing, active trigger points and tenderness) have not been investigated.
OBJECTIVES
To i) update evidence for cervical musculoskeletal impairments in migraine and tension-type headache ii) report on accompanying pain associated with testing, active trigger points and tenderness in headache; iii) determine relationships between these sensitivity features and cervical musculoskeletal impairments in headache.
METHODS
Five databases were searched for observational studies. Quality of studies was assessed with JBI Critical Appraisal. Meta-analysis was performed using random effect models. Certainty of the evidence was assessed using GRADE.
RESULTS
Seventy-seven studies were included comprising 2551 participants. New findings in migraine were increased forward head posture in standing (MD = -2.51°[-4.94°, -0.09°]), reduced flexion/rotation range (MD = -9.47°[-15.78°, -3.16°]), reduced flexor strength (Std. MD = -0.34[-0.57, -0.10]) and endurance (MD = -14.37[-28.15, -0.58]), and reduced extensor strength (Std. MD = -0.34[-0.60, -0.08]) in migraine. Tension-type headache had reduced extensor strength (Std. MD = -0.45[-0.85, -0.04]). Certainty was very low for all findings due to heterogeneity and small effect size. Active trigger points and tenderness were common, particularly, in…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,551 participants or records.
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