Les,
"provoking cluster-type referred pain" by means of "myofascial trigger points (MTrPs)" is not a CH Les. Neither is a nitrate induced CH, nor an alcohol induced CH.
They are all induced. Ask anyone getting belted every morning at 4am, this is not "induced".
"Combined with prophylactic drug therapy, injections (local anesthetic) were associated with significant improvement in 7 of the 8 chronic cluster patients" - this is not CH relief from "trigger points".
induced: past participle, past tense of in·duce (Verb)
Verb - Succeed in persuading or influencing (someone) to do something.
Bring about or give rise to: "measures that induced a change".
"Myofascial trigger points in cluster headache patients: a case series."
I know the title is sexy Les, but do you actually read the stuff you post?
This particular study has no relevance to the studies in the trigger point workbook or the point you attempt to make about it.
A search of "Travell & Simons" studies in trigger point therapy works brings up more sales opportunities than I have seen in a while. Their over 3000 times cited link, redirects not to a trial result, but to a book sale.
They also fail to make a differential distinction between headache types, subtypes or syndromes, as per the IHS diagnostic criteria:
"According to Doctors Janet Travell and David Simons in their widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual, myofascial trigger points (tiny contraction knots) in overworked or traumatized muscles are the hidden and unsuspected cause of most headaches. This includes tension headaches, cervicogenic headaches, cluster headaches, vascular headaches, and migraine headaches."
- "hidden and unsuspected cause of most headaches".
I know a scientist or two who would object, backing themselves with fact.
Pressing on nerves to induce cluster-like pain is a trick many illegitimate practitioners use. It is a parlour trick and should be rooted out of Universities.
Due to the training boom of the last 20 years (No Australian HECS bills for overseas students either...take the training at taxpayer expense and run...), a lot of crap has infiltrated Universities and is dragging them down as a result. Friends of Science and medicine are attempting to do this. Go back to the FSM link and have a look at the research that 75% of all academics consider to be quackery, it is long.
Did you know you can submit a thesis and obtain a Doctoral PhD on "The Beatles" Les?
Hardly contributing to Science.
True CH happens without a known causative factor.
That's why we are all here.
If Travell & Simons have found a unifying causative factor in CH, my specialist is out of a job. I am sure he would be delighted.
Unfortunately, I have to get off to the hospital now.
I will be back onto this more thoroughly later, if necessary.
Ben.
This post was edited on 22/03/2013 at 4:19 pm