Myofascial Therapy is based on a number of ideas, including:

1) injured or stressed muscles form 'knots' or Myofascial Trigger Points,
2) these knots are tender and can create pain locally, and
3) pain can be referred to structures in other parts of the body.

The referral of pain can seem mysterious to the average person - for example, the idea that a small tender spot on muscle over the shoulder blade would affect the arm or hand may not be intuitive. But the idea of referred pain is accepted by modern medicine (the arm and shoulder pain related to a heart attack is one example that is somewhat well known).

Is myofascial therapy relevant to CH? My personal opinion is that is probably most relevant for dealing with secondary phenomenon like Cluster Lumps. Here is a discussion I came across of the effectiveness of the techniques.



Although I am not optimistic that this therapy will do wonders for CH, it is of interest to note the relationship between headache behind the eye and muscles in the neck. My assumption is that in CH, the relationship is mostly one way - the intense pain behind the eye is referred to the neck, where it causes muscular problems. On the other hand, there could be a 2-way flow of pain. Consider nerve blocks, which can sometimes prevent cluster headaches: these are therapies that primarily affect the nerves and muscles in the neck, not the hypothalamus.

Deactivating or 'releasing' myofascial trigger points can be done in several ways. Initially, it was done by doctors with injections of anti-inflammatory medicines. This has been replaced by a 'freeze and stretch' method that some massage therapists and physical therapists use. Most importantly, a variety of do it yourself massage techniques have been developed, and these can be carried out with simple, improvised tools.

DIY myofascial massage requires deep pressure and smooth, relatively short strokes. It should be performed frequently through out the the day (6-8 times according to some sources) to rehabilitate the muscle. Most therapists recommend that the strokes go parallel to the grain of the affected muscle. The intensity of the pressure varies with the thickness of the muscle, and the degree of pain experienced. Getting an inexpensive book (like The Trigger Point Therapy Workbook, about $15) is a good way to get started, and the techniques are relatively simple and can be applied to many musculoskeletal conditions).


Side notes:

I got interested in myofascial therapy after my right arm started locking up and I became unable to lift it normally (probably from too much mousing on the computer). After reading The Trigger Point Therapy Workbook I discovered a number of tender spots on my shoulder blade and shoulder. Within a few days, regular massage of these points led to a dramatic improvement. After 10 days, I had completely recovered.

I have aborted an ocular migraine by locating painful spots on the cheeks; I began massaging the face and located 2 spots on the cheeks (directly under the eyes). These spots were not only painful, but caused a momentary flare in the optical symptoms. My typical optical migraines last 20 to 40 minutes; this one lasted about 3 minutes; I was two minutes into it when I began the myofascial maneuvers.

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