The role of postural factors in the pathogenesis of tension-type headache in children

Introduction . Primary headaches (PH), including tension-type headache (TTH), have a strong negative impact on the quality of life and academic success of children. Posture disorders, particularly upper crossed syndrome (UCS), play an important role in the development and chronicization of TTH. Aim. To study the influence of UCS on the clinical picture of TTH in children and the effectiveness of non-pharmacological methods of correction. Materials and methods. A total of 113 children aged 14–17 years were examined. Frequent or chronic TTH with the presence of UCS was diagnosed in 70 children (main group), 43 children with infrequent TTH or without headache without TTH were included in the control group. Examination included history taking, neurological examination, posture assessment with laser leveler and mechanoalgometry. Treatment included kinesiotaping and training of correct motor stereotype. Results. Patients with UCS showed significantly greater forward head tilt angle, asymmetry of the shoulder girdle, decreased pain threshold of pericranial muscles, increased frequency and intensity of headache compared to controls (p < 0.001). Three months after treatment, there was a statistically significant decrease in head tilt angle, asymmetry of the shoulder girdle, increase in pain threshold and decrease in headache intensity and frequency (p < 0.001) to the level of the control group. Conclusions. UCS is a significant factor in the development and chronicization of TTH in children. Non-medicamentous correction with kinesiotaping and training in correct motor stereotypes are effective in restoring normal posture and reducing clinical manifestations of TTH.