Women vs men with tension-type headache (TTH) may have a higher number of trigger points (TrPs) and lower pressure pain thresholds (PPTs), according to a study published in Pain Practice.

The study included participants with TTH (n=210; 72% women) who were asked to complete a headache diary over a 4-week period. The presence of TrPs was examined bilaterally in the temporalis, masseter, suboccipital, upper trapezius, splenius capitis, and sternocleidomastoid muscles. The State-Trait Anxiety Inventory was used to assess trait and state anxiety levels. PPTs were assessed over the temporalis, the C5/C6 joint, the second metacarpal, and the tibialis anterior.

Women vs men with TTH were found to have a higher number of total (P =.027) and active (P =.030) TrPs. Men and women with TTH had comparable numbers of latent TrPs (P =.461). In both men and women, active TrPs were most prevalent in the temporalis, suboccipital, and splenius capitis muscles. In addition, a higher number of active TrPs was found to be associated with greater levels of anxiety in women (r=.217; P =.045). This association was not present in men (P =.453). Women were found to have lower PPTs compared with men (P <.001).

Continue Reading

The number of active — but not latent — TrPs was negatively associated with localized PPTs in men (P <.05 for all). In women, the number of active and latent TrPs was negatively associated with PPTs (P <.01 for all).

“Our findings suggest the presence of potential gender differences in the role of TrPs between men and women with TTH,” the researchers noted.


Cigarán-Méndez M, Jiménez-Antona C, Parás-Bravo P, Fuensalida-Novo S, Rodríguez-Jiménez J, Fernández-de-Las-Peñas C. Active trigger points are associated with anxiety and widespread pressure pain sensitivity in women, but not men, with tension type headache. [published online February 13, 2019]. Pain Pract. doi:10.1111/papr.12775

Related Articles

This article originally appeared on Clinical Pain Advisor