A pilot study on non-invasive treatment of migraine: The self-myofascial release

Submitted: 28 January 2021
Accepted: 3 February 2021
Published: 10 February 2021
Abstract Views: 1831
PDF: 662
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


  • Alessandra Amato Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy.
  • Giuseppe Messina Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy.
  • Valerio Giustino Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy.
  • Jessica Brusa Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy.
  • Filippo Brighina Department of Experimental Biomedicine and Clinical Neurosciences (BIONEC), University of Palermo, Palermo, Italy.
  • Patrizia Proia Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy.

The aims of this paper was to determine the effect of self-myofascial release (SMFR) on postural stability and to analyze if it can influence migraine condition. Twenty-five subjects (age 49.7± 12.5) affected by migraine were enrolled. Assessments included a stabilometric analysis in order to evaluate balance and plantar support, with eyes open (OE) and closed (CE); cervical ROM measurement; evaluation of upper limb strength through handgrip. All the analysis were carried out before and after the administration of a single SMFR protocol, using medium density small balls laid in the three most painful trigger points in migraine patients: trapezius, sternocleidomastoids and suboccipital muscles. Performing a T test for paired samples, there was a significant increase in two ranges of the stabilometric analysis: ellipse surface, both with open and closed eyes (p value EO = 0.05; p value EC = 0.04) and length of the sway path, but just with closed eyes (p value = 0.05). SMFR might have a positive impact on postural stability in subjects with migraine. Further investigation should be conducted to confirm the hypothesis.

Kalichman L, Ben David C. Effect of Self- Myofascial Release on Myofascial Pain, Muscle Flexibility, and Strength: A Narrative Review. 2017 Apr;21(2):446-451. DOI: https://doi.org/10.1016/j.jbmt.2016.11.006

Rutherford G, Manning P, Newton JL. Understanding Muscle Dysfunction in Chronic Fatigue Syndrome. J Aging Res. 2016;2016: 2497348. DOI: https://doi.org/10.1155/2016/2497348

Burstein R, Noseda R, Borsook D. Migraine: Multiple Processes, Complex Pathophysiology. J Neurosci. 2015 Apr 29;35(17):6619-29. DOI: https://doi.org/10.1523/JNEUROSCI.0373-15.2015

Liang Z, Galea, O, Thomas L, Jull G, Treleaven J. Cervical Musculoskeletal Impairments in Migraine and Tension Type Headache: A Systematic Review and Meta-Analysis. Musculoskelet Sci Pract. 2019 Jul;42:67-83. DOI: https://doi.org/10.1016/j.msksp.2019.04.007

Baraldi C, Gherpelli C, Alicandri Ciufelli M, Monzani D, Pini LA, Pani L.,Guerzoni S. A Case- Control Study of Visually Evoked Postural Responses in Childhood with Primary Headaches. Neurol Sci. 2020 Feb;41(2):305-311. DOI: https://doi.org/10.1007/s10072-019-04072-2

Blaschek A, Milde-Busch A, Straube A, chankin C, Langhagen T, Jahn K, Schröder SA, Reiter K, von Kries R, Heinen F. Self-Reported Muscle Pain in Adolescents with Migraine and Tension-Type Headache. Cephalalgia. 2012 Feb;32(3):241-9. DOI: https://doi.org/10.1177/0333102411434808

Beardsley C, Škarabot J. Effects of Self-Myofascial Release: A Systematic Review. J Bodyw Mov Ther. 2015 Oct;19(4):747-58. DOI: https://doi.org/10.1016/j.jbmt.2015.08.007

Langevin HM, Sherma, KJ. Pathophysiological Model for Chronic Low Back Pain Integrating Connective Tissue and Nervous System Mechanisms Med Hypotheses. 2007;68(1):74-80. DOI: https://doi.org/10.1016/j.mehy.2006.06.033

Fernández-de-las-Peñas C, Cuadrado M, Pareja J. Myofascial Trigger Points, Neck Mobility and Forward Head Posture in Unilateral Migraine. Cephalalgia. 2006 Sep;26(9):1061-70. DOI: https://doi.org/10.1111/j.1468-2982.2006.01162.x

Langevin HM, Storch KN, Cipolla MJ, White SL, Buttolph TR, Taatjes DJ. Fibroblast Spreading Induced by Connective Tissue Stretch Involves Intracellular Redistribution of α- and β-Actin. Histochem Cell Biol. 2006, May;125(5):487-95. DOI: https://doi.org/10.1007/s00418-005-0138-1

Kreis TE, Birchmeier W. Stress Fiber Sarcomeres of Fibroblasts Are Contractile. Cell. 1980 Nov;22(2 Pt 2):555-61. DOI: https://doi.org/10.1016/0092-8674(80)90365-7

Ingber D. Mechanobiology and Diseases of Mechanotransduction. Ann Med. 2003;35(8):564-77. DOI: https://doi.org/10.1080/07853890310016333

McAnulty RJ. Fibroblasts and Myofibroblasts: Their Source, Function and Role in Disease. Int J Biochem Cell Biol. 2007;39(4):666-71. DOI: https://doi.org/10.1016/j.biocel.2006.11.005

Stecco A, Meneghini A, Stern R.; Stecco C, Imamura M. Ultrasonography in Myofascial Neck Pain: Randomized Clinical Trial for Diagnosis and Follow-Up. Surg Radiol Anat. 2014 Apr;36(3):243- 53. DOI: https://doi.org/10.1007/s00276-013-1185-2

Schleip R, Klingler W, Lehmann-Horn F. Active Fascial Contractility: Fascia May Be Able to Contract in a Smooth Muscle-like Manner and Thereby Influence Musculoskeletal Dynamics. Med Hypotheses. 2005;65(2):273-7. DOI: https://doi.org/10.1016/j.mehy.2005.03.005

Porter KE, Turner NA. Cardiac Fibroblasts: At the Heart of Myocardial Remodeling. Pharmacol Ther. 2009;123(2):255-78. DOI: https://doi.org/10.1016/j.pharmthera.2009.05.002

Schleip R, Duerselen L, Vleeming A, Naylor IL, Lehmann-Horn F, Zorn A, Jaeger H, Klingler W. Strain Hardening of Fascia: Static Stretching of Dense Fibrous Connective Tissues Can Induce a Temporary Stiffness Increase Accompanied by Enhanced Matrix Hydration. J Bodyw Mov Ther. 2012, Jan;16(1):94-100. DOI: https://doi.org/10.1016/j.jbmt.2011.09.003

Fernández-de-las-Peñas C, Florencio LL, Plaza- Manzano G, Arias-Buría JL. Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review. Int J Environ Res Public Health. 2020 Jun 9;17(11):4126. DOI: https://doi.org/10.3390/ijerph17114126

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd Edition (Beta Version). Cephalalgia. Jul;33(9):629-808. DOI: https://doi.org/10.1177/0333102413485658

Moraska A, Chandler C. Changes in Clinical Parameters in Patients with Tension-Type Headache Following Massage Therapy: A Pilot Study. J Man Manip Ther. 2008;16(2):106-12. doi: 10.1179/106698108790818468. DOI: https://doi.org/10.1179/106698108790818468

Hou C.-R, Tsai L-C, Cheng K-F, Chung K-C, Hong C-Z. Immediate Effects of Various Physical Therapeutic Modalities on Cervical Myofascial Pain and Trigger-Point Sensitivity. Arch Phys Med Rehabil. 2002 Oct;83(10):1406-14. doi: 10.1053 /apmr.2002.34834. DOI: https://doi.org/10.1053/apmr.2002.34834

Fernandez-de-las-Penas C, Alonso-Blanco C, Cuadrado ML, Gerwin RD, Pareja JA. Myofascial Trigger Points and Their Relationship to Headache Clinical Parameters in Chronic Tension-Type Headache. 2006 Sep;46(8):1264-72. doi: 10.1111/j.1526-4610.2006.00440.x. DOI: https://doi.org/10.1111/j.1526-4610.2006.00440.x

Alonso-Blanco C, de-la-Llave-Rincón AI, Fernández-de-las-Peñas C. Muscle Trigger Point Therapy in Tension-Type Headache. Expert Rev Neurother. 2012 Mar;12(3):315-22. doi: 10.1586/ern.11.13. DOI: https://doi.org/10.1586/ern.11.13

Fernández-de-las-Peñas, C.; Ge, H.-Y.; Alonso- Blanco, C.; González-Iglesias, J.; Arendt-Nielsen, L. Referred Pain Areas of Active Myofascial Trigger Points in Head, Neck, and Shoulder Muscles, in Chronic Tension Type Headache. J Bodyw Mov Ther. 2010, Oct;14(4):391-6. doi: 10.1016/j.jbmt.2009.06.008. DOI: https://doi.org/10.1016/j.jbmt.2009.06.008

Moraska AF, Stenerson L, Butryn N, Krutsch JP, Schmiege SJ, Mann JD. Myofascial Trigger Point- Focused Head and Neck Massage for Recurrent Tension-Type Headache: A Randomized, Placebo- Controlled Clinical Trial. Clin J Pain. Feb; 31(2):159-68. doi: 10.1097/AJP.0000000000 000091.

Connolly G, Hammer RL, Powell JA, O’Connor PL. A Single Bout of Foam Rolling Increases Flexibility of the Hip Adductor Muscles without Compromising Strength. Int J Exerc Sci. 2020 Aug 1;13(7):938-949.

Patti A, Bianco A, Şahin N, Sekulic D, Paoli A, Iovane A, Messina G, Gagey PM, Palma A. Postural Control and Balance in a Cohort of Healthy People Living in Europe: An Observational Study. Medicine (Baltimore). 2018 Dec;97(52):e13835. doi: 10.1097/MD.0000000000013835. DOI: https://doi.org/10.1097/MD.0000000000013835

Carvalho GF, Schwarz A, Szikszay TM, Adamczyk WM, Bevilaqua-Grossi D, Luedtke K. Physical Therapy and Migraine: Musculoskeletal and Balance Dysfunctions and Their Relevance for Clinical Practice. Braz J Phys Ther. Jul-Aug 2020;24(4):306-317. doi: 10.1016/j.bjpt.2019.11.0 01.

Messina G, Giustino V, Martines F, Rizzo S, Pirino, A, Scoppa F. Orofacial Muscles Activity in Children with Swallowing Dysfunction and Removable Functional Appliances. Eur J Transl Myol. 2019, Aug 27;29(3):8267. DOI: https://doi.org/10.4081/ejtm.2019.8267

WuH,LiuM,ZhangQ,LiuL,MengG,BaoX,Gu Y, Zhang S, Sun S, Wang X, Zhou M, Jia Q, Song K, Niu K Reference values for handgrip strength: data from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study. Age Ageing. 2020 Feb 27;49(2):233-238.

Amato, A., Messina, G., Giustino, V., Brusa, J. ., Brighina, F., & Proia, P. (2021). A pilot study on non-invasive treatment of migraine: The self-myofascial release. European Journal of Translational Myology, 31(1). https://doi.org/10.4081/ejtm.2021.9646


Download data is not yet available.