Is Manual Examination of Active Myofacial Trigger Points in Patients with Tension-Type Headache Reliable? Interrater Reliability Trial

Manual examination is the easiest method of diagnosing myofascial trigger points. The affected muscle is examined by using clinical (spot tenderness within a taut band, pain recognition through mechanical stimulation) and additional diagnostic criteria (referred pain). However, currently the reliability of the manual examination of mTrP has been discussed controversially. This study determined the interrater reliability of palpatory examination of the clinical and additional diagnostic criteria as well as the overall assessment and localisation of active mTrP in the sternocleidomastoid muscle in patients with tension-type headache. The diagnostic criteria taut band, local tenderness, symptom reproduction and referred pain shows an adequate to moderate interrater reliability. The criteria taut band and spot tenderness as well as the overall assessment of active mTrP show no to poor compliance.