Head / Face
Frontalis Muscle Tension Headache
전두근 긴장 두통
Pressing frontal headache from sustained frontalis muscle contraction and trigger points
- How common
- Common (TTH subtype)
- Typical age
- Ages 20–50
What is it?
Habitual brow furrowing, visual strain, and stress sustain frontalis contraction with trigger points producing pressing frontal headache via the galea aponeurotica.
Commonly affected: Frontalis (frontal belly of occipitofrontalis)
How it develops
- Visual Strain/FurrowingRefractive error and screen focus drive repeated contraction
- Sustained ContractionIncreased frontalis tone
- Trigger Point FormationTaut bands over mid-forehead and brow
- Referred SpreadReferral extends across galea to vertex
Symptoms
- Frontal pressing painBilateral band-like pressing over forehead
- Heavy supraorbital feelingHeaviness and fatigue above brows
- Associated eye strainWorse after prolonged screen use
- Brow furrowing habitUnconscious frontalis contraction
- Relief with rest/sleepSubsides after the day ends
How it is examined
- Frontalis tendernessTaut band 1–2 cm above brow
- TrP reproductionPalpation reproduces frontal/vertex pain
- Refractive screeningNear vision/astigmatism screening
- Normal neurologic examCranial nerves, sensation, strength normal
Imaging
Generally unnecessary; sinus film if sinusitis suspected.
- Usually normal
- Clear sinuses
- Normal osseous structures
Clinical diagnosis; MRI only for red flags to exclude secondary causes.
- Usually normal
- No structural lesion
- US may show taut bands in frontalis
Non-surgical care
- Visual hygiene/refraction20-20-20 rule, updated eyewear
- Furrow awareness/relaxationBiofeedback and forehead relaxation
- Heat/massageWarm compress and myofascial release
- Trigger point therapyDry needling or ischemic compression
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
No surgical indication
Procedures that may be discussed
- Conservative care only
Outlook
Most improve with habit change and visual care.