Behavioral intervention with muscle-contraction headache: a review.

Studies involving behavioral intervention with muscle-contraction headache are reviewed. Intervention approaches have most frequently involved frontal electromyographic feedback and relaxation instructions. Although behavioral intervention packages have been more effective than control procedures in reducing headache activity, identification of active components of these packages is difficult. Specifically,, the contribution of placebo, expectancy and demand factors, reactive effects of self-monitoring, and home practice have not been adequately assessed. The importance of assessing individual differences in etiology and in response to intervention is stressed. The results of some studies are congruent with the hypothesized muscle tension etiology of muscle-contraction headaches but the results from others suggest that factors other than muscle-tension may be involved. Supportive laboratory research on the intervention procedures and cost-efficiency of electromyographic feedback and relaxation instructions are discussed.