Background: Several peripheral and central factors are believed to contribute to the pathology of tension type headache (TTH). We carried out this study to identify a connection between TTH and flat feet.
Methods: This is a cross-sectional comparative study. A total of 61 people with chronic TTH (13 male and 48 female) and 61 matched controls participated in this study. The frequency of flat feet in the two groups was the primary outcome of this study. The presence of myofascial trigger points in the head and neck areas and degree of neck disability were also assessed in both groups. A Pearson's chi-square test and logistic regression models were used to determine the relative contribution of demographic and clinical predictive variables to the TTH.
Results: The chi-square test showed that frequency of flat feet, uni- or bilateral, was significantly higher (x2= 17.5, df= 2, p<0.001) in TTH group compared the control group. Further analysis revealed that people with flat feet are 4.32 to 5.05 times more likely to develop TTH than people who have normal foot posture. The probability of developing TTH in participants with 4 or more trigger points was 7.93 times higher than participants with less than 4 trigger points. Similarly; the probability of developing TTH in participants with a Neck Disability Index score of 4 or more was 11.96 times higher than participants with a score less than 4.
Conclusion: Our findings indicate that there is a probable link between presence of flat feet and chronic TTH.