None listed
Conditions
Brief summary
Neck pain is an important issue in primary headache. It contributes to costs and disability and is associated with poorer treatment outcomes and migraine chronicity. Current knowledge suggests pain sensitisation mechanisms and/or cervical musculoskeletal dysfunction account for the presence of neck pain in migraine and other primary headaches. Recent research suggests up to 40% of patients demonstrate signs of cervical musculoskeletal dysfunction. Better understanding of the nature of neck pain and function in primary headache is needed as this has important implications for management. This research will explore targeted management of the upper cervical spine to identify potential responders and non-responders. The study hypothesis is that a sub-group of migraine sufferers will report reduced migraine frequency and impact following the physiotherapy intervention.
Interventions
Pilot study / Clinical trial of a combination of physiotherapy musculoskeletal management strategies focussed on upper cervical rotation on the frequency of migraine. Intervention will include:
-Manual therapy (mobilisation only) to the upper cervical and thoracic region joints .
-Frequency of the intervention- 1 x 1 hour sessions per week for 4 weeks face to face. -Administered by a physiotherapist with over 30 years experience of managing neck pain and headache.
Adherence to the intervention
Pilot study / Clinical trial of a combination of physiotherapy musculoskeletal management strategies focussed on upper cervical rotation on the frequency of migraine. Intervention will include: -Manual therapy (mobilisation only) to the upper cervical and thoracic region joints . -Frequency of the intervention- 1 x 1 hour sessions per week for 4 weeks face to face. -Administered by a physiotherapist with over 30 years experience of managing neck pain and headache. Adherence to the intervention will be monitored by a session attendance checklist and documentation of adherence to self-management strategies at each session.
Sponsors
University of Queensland
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Primary headache is migraine, can have other headaches but migraine is main headache Unilateral headache At least 8 headaches over the previous 12 weeks Headache associated with neck pain Neck symptoms associated with subjective tightness in neck rotation Migraine can be triggered by neck positioning and or movement Participant aged 18-65 Need to be available to attend for 4 one hour physiotherapy sessions and a pre- & post- treatment musculoskeletal assessment over the study period: a 4-6 week period. Likely March-April 2025.
Exclusion criteria
More than 15 headaches (HA) per month Specific disorders and congenital conditions of the cervical spine (e.g., past cervical spine surgery, infection, tumour, fracture, diffuse idiopathic skeletal hyperostosis, degenerative joint disease, stenosis) Receiving any manual therapy treatment to neck or head in the past 3 months Neck and head trauma requiring medical care/ hospitalisation in the past 3 months Contraindications to study treatments (e.g., inflammatory arthropathies, cervical instability, severe osteoporosis, vertigo, dizziness) Surgery in temporomandibular joint (TMJ) area Any history of neurological disorders eg. multiple sclerosis, amyotrophic lateral sclerosis (ALS), Parkinson’s, myelopathy, seizures, cervical radiculopathy, herniated disc, thoracic outlet syndrome, brachial plexus neuropathy) and cardiovascular disorders (history of stroke, transient ischemic attacks, stage 2 hypertension, taking anticoagulant medication, syncope, myocardial infarction, haemophilia) Pregnancy, trying to get pregnant, 3 months post-partum Active or pending medical litigation, personal injury, workers compensation; disability compensation related to a head or neck injury Relevant cancer in the past five years. EXCLUSION CRITERIA PHYSICAL ASSESSMENT Excluded if no joint signs OR if joint signs at > 3 levels Excluded if normal range of motion (ROM) on cervical flexion rotation tests (CFRT).
Outcome results
None listed