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TRIGGER POINT OF THE WEEK – OCCIPITOFRONTALIS/EPICRANIUS


Trigger points in the occipitofrontalis muscle may have profound and nasty consequences in the forms of intractable headaches. The epicranius is really the only muscle of the scalp and it is used to raise the eyebrows and wrinkle the forehead – it is very much a muscle of expression. It is composed of two parts, the occipital part and the frontal – connected by the fascial galea aponeurotica. It is woth noting here that the galea also receives some connections to the myofascia of Temporalis muscle. In terms of the originsoccipitalis: lateral two-thirds of superior nuchal line of occipital bone. Mastoid process of temporal bone; Frontalis: galea aponeurotica. The insertions are as follows: occipitalis: galea aponeurotica (a sheet-like tendon leading to frontal belly); Frontalis: fascia and skin above eyes and nose. Similarly, in terms of trigger point referred pain patterns for the occipitofrontalis there are two distinct maps: occipitalis: pain in lateral and anterior scalp; diffuse into back of head and into orbit. Frontalis:localized pain with some referral upward and over forehead on same side (ipsilateral).



MUSCLE COMMENT


The galea aponeurotica is named because it forms what resembles a helmet upon the skull. In general trigger points in the occipitofrontalis muscle are perceived as headache rather than myofascial pain. Trigger points in the frontalis muscle often present as a searing, caustic pain in the eye socket. Trigger points in the occipitalis tend to present as a more vague type of headache in the posterior cranium.


How do you treat trigger these trigger points? We’d be delighted if you want to share your own best practice.

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