Differential effectiveness of EMG-feedback versus combined EMG-feedback and relaxation instructions in the treatment of tension headache.

After a 2 1/2 week baseline period 18 muscle tension headache patients were randomly assigned to one of three conditions: waiting list, formal EMG-feedback training, combined training of EMG-feedback and progressive relaxation. Patients in the two treatment conditions obtained 12 training sessions and returned 3 months after treatment for a follow-up session. Both treatment conditions were equivalent in their effect on EMG of m. frontalis and on headache scores, against stability for waiting list patients as observed in a separate analysis. Changes over treatment in both parameters were significantly correlated. Among changes in headache subparameters, the only significant correlation with changes in frontalis EMG was found for duration of pain. In both treatment conditions a generalizing effect to neck muscles was observed. Among personality variables decreases were found in neuroticism and somatization at follow-up for the combined training conditions, whereas the EMG-feedback alone condition remained unaltered. The combined training condition also proved superior in reducing operant pain behavior.