Efficacy of a workplace relaxation exercise program on muscle tenderness in a working community with headache and neck pain: a longitudinal, controlled study

Eur J Phys Rehabil Med. 2016 Aug;52(4):457-65. Epub 2016 Jan 8.


Background: Pericranial muscle tenderness shows a remarkable prevalence not only in tension-type headache, but also in migraine, both episodic and chronic. Neck pain is a common disorder and leads to a high rate of work disability; its prevalence increases for headache.

Aim: This study aimed at examining the effects of a relaxation exercise programme on pericranial/cervical muscle tenderness in a working community with headache and neck pain.

Design: This was a controlled, non-randomized trial.

Setting: The study was carried out in a working community, on the employees of the City of Turin's central and peripheral registry and tax offices.

Population: A total of 384 workers were enrolled and divided into two groups: a study group (group 1; 192 subjects) and a control group (group 2; 192 subjects).

Methods: A programme, with relaxation/posture exercises and a visual feedback, was carried out for Group 1 for 6 months and, afterwards, also for group 2 for the same follow-up period throughout. Data on head/neck pain were collected. Standard palpation of pericranial and cervical muscles was done, scoring each patient for Pericranial Muscle Tenderness (PTS) (0-3), Cervical Muscle Tenderness (CTS) (0-3) and a Cumulative Muscle Tenderness (CUM) (0-6).

Results: After 6 months from baseline, a significant difference was observed between the groups: i.e. group 1 had an average change from baseline of -0.19 for PTS, -0.2 for CTS and -0.36 for the CUM score - in association with a reduction in headache, neck and shoulder pain. The difference between the groups in PTS, CTS and CUM scores was no longer detectable at the end of the study, after also group 2 performed the programme.

Conclusions: The administration of a workplace relaxation exercise intervention significantly decreased pericranial/cervical muscle tenderness in the working community, in association with head-neck pain benefit.

Clinical rehabilitation impact: This relaxation exercise programme was remarkably cost-effective, yielding a relevant benefit on pericranial/cervical muscle tenderness in a working community, at a relatively low cost.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Age Factors
  • Confidence Intervals
  • Exercise Therapy / methods
  • Female
  • Follow-Up Studies
  • Headache / diagnosis
  • Headache / rehabilitation*
  • Humans
  • Linear Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Myalgia / diagnosis
  • Myalgia / rehabilitation*
  • Neck Pain / diagnosis
  • Neck Pain / rehabilitation*
  • Occupational Diseases / diagnosis
  • Occupational Diseases / rehabilitation*
  • Pain Measurement
  • Relaxation Therapy / methods*
  • Risk Assessment
  • Sex Factors
  • Tension-Type Headache / diagnosis
  • Tension-Type Headache / rehabilitation
  • Treatment Outcome
  • Workplace