A11.2.5 Headache attributed to cervical myofascial pain

Diagnostic criteria:
A. Head and/or neck pain fulfilling criterion C
B. A source of myofascial pain in the muscles of the neck, including reproduceable trigger points, has been demonstrated
C. Evidence of causation demonstrated by at least two of the following:

    1. either or both of the following:

      a) pain has developed in temporal relation to onset of the cervical myofascial pain disorder
      b) pain has significantly improved in parallel with improvement in the cervical myofascial pain disorder

    2. significant pressure-tenderness is elicited in cervical muscles corresponding to the pain perceived by the patient
    3. pain is temporarily abolished by local anaesthesic injections into trigger points, or by trigger point massage

D. Not better accounted for by another ICHD-3 diagnosis.

Myofascial pain and its relation to so-called “trigger points” is controversial. It has been difficult consistently to demonstrate supposed trigger points, and response to treatment varies.