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Both upper trapezius muscles were examined for the presence of myofascial trigger points (TrPs) in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold (PPT) were recorded. The results show that referred pain was evoked in 85% and 50% on the dominant and non\u2010dominant sides in CTTH patients, much higher than 55% and 25% in controls (<jats:italic>P<\/jats:italic>&lt;0.01). Referred pain spread to the posterior\u2010lateral aspect of the neck ipsi\u2010lateral to the stimulated muscle in both patients and controls, with additional referral to the temple in most patients, but none in controls. Nearly half of the CTTH patients (45%) recognized the referred pain as their usual headache sensation, i.e. active TrPs. CTTH patients with active TrPs in the right upper trapezius muscle showed greater headache intensity and frequency, and longer headache duration than those with latent TrPs. CTTH patients with bilateral TrPs reported significantly decreased PPT than those with unilateral TrP (<jats:italic>P<\/jats:italic>&lt;0.01). Our results showed that manual exploration of TrPs in the upper trapezius muscle elicited referred pain patterns in both CTTH patients and healthy subjects. In CTTH patients, the evoked referred pain and its sensory characteristics shared similar patterns as their habitual headache pain, consistent with active TrPs. Our results suggest that spatial summation of perceived pain and mechanical pain sensitivity exists in CTTH patients.<\/jats:p>","DOI":"10.1016\/j.ejpain.2006.07.005","type":"journal-article","created":{"date-parts":[[2006,8,22]],"date-time":"2006-08-22T12:06:00Z","timestamp":1156248360000},"page":"475-482","source":"Crossref","is-referenced-by-count":120,"title":["Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache"],"prefix":"10.1002","volume":"11","author":[{"given":"C\u00e9sar","family":"Fern\u00e1ndez\u2010de\u2010las\u2010Pe\u00f1as","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong\u2010You","family":"Ge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"Arendt\u2010Nielsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Luz","family":"Cuadrado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan A.","family":"Pareja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0079-6123(00)29026-2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2003.00520.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awf166"},{"key":"e_1_2_6_5_1","first-page":"IC\u201059","volume-title":"A critical review of epidemiologic evidence for work\u2010related musculoskeletal disorders of the neck, upper extremity, and low back","author":"Bernard B.","year":"1997"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-001-0029-7"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2005.00962.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2006.00288.x"},{"key":"e_1_2_6_9_1","first-page":"145","article-title":"Application of pressure algometry in manual medicine","volume":"5","author":"Fischer A.A.","year":"1990","journal-title":"J Man Med"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1090-3801(03)00033-8"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2004.01.017"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20410"},{"key":"e_1_2_6_13_1","first-page":"1","volume-title":"Clinical mastery in the treatment of myofascial pain","author":"Gerwin R.","year":"2005"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(96)03248-4"},{"key":"e_1_2_6_15_1","unstructured":"IHS: The International Classification of headache disorders:Headache classification subcommittee of the International Headache Society. 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