Changes in Psychological Parameters in Patients with Tension-type Headache Following Massage Therapy: A Pilot Study

Abstract

Investigations into complementary and alternative medicine (CAM) approaches to address stress, depression, and anxiety of those experiencing chronic pain are rare. The objective of this pilot study was to assess the value of a structured massage therapy program, with a focus on myofascial trigger points, on psychological measures associated with tension-type headache. Participants were enrolled in an open-label trial using a baseline control with four 3-week phases: baseline, massage (two 3-week periods) and a follow-up phase. Eighteen subjects with episodic or chronic tension-type headache were enrolled and evaluated at 3-week intervals using the State-Trait Anxiety Inventory, Beck Depression Inventory, and the Perceived Stress Scale. The Daily Stress Inventory was administered over 7-day periods during baseline and the final week of massage. Twice weekly, 45-minute massage therapy sessions commenced following the baseline phase and continued for 6 weeks. A significant improvement in all psychological measures was detected over the timeframe of the study. Post hoc evaluation indicated improvement over baseline for depression and trait anxiety following 6 weeks of massage, but not 3 weeks. A reduction in the number of events deemed stressful as well as their respective impact was detected. This pilot study provides evidence for reduction of affective distress in a chronic pain population, suggesting the need for more rigorously controlled studies using massage therapy to address psychological measures associated with TTH.

Keywords: Beck Depression Inventory; Complementary and Alternative Medicine; Daily Stress Inventory; Myofascial Pain; State-Trait Anxiety Inventory.

FIGURE 1

Scores for the state and trait subscales of the State-Trait Anxiety Inventory (STAI) are presented as the mean ±95% CI. A significant change in state and trait anxiety was detected across the study timeframe (p<0.01). ∗Denotes p< 0.01 compared to respective baseline.

FIGURE 2

Scores for the Beck Depression Inventory (BDI-II) are presented as the mean ±95% CI. A significant change in the BDI-II was detected across the study timeframe (p<0.01). ∗Denotes p< 0.01 compared to baseline.

FIGURE 3

Scores for the Perceived Stress Scale (PSS) are presented as the mean±95% CI. A significant change in the PSS was detected across the study timeframe (p<0.01). ∗Denotes p< 0.01 compared to baseline.

FIGURE 4

Scores for the Daily Stress Inventory (DSI) are presented. The number of events considered stressful, their respective impact, and the Impact:Event ratio was determined over 7-day periods during baseline and the end of the treatment phase. ∗Denotes p< 0.02 compared to respective baseline.