Cervicogenic Headache
Conditions
Keywords
cervicogenic headache, trigger point, sternocleidomastoid, manual therapy
Brief summary
It is a pilot randomized controlled trial comparing real and simulated manual treatment of trigger points (TrPs) in patients with cervicogenic headache (CeH). The purpose of the current randomized clinical pilot trial was to determine the preliminary effects of TrP manual therapy in individuals with CeH with sternocleidomastoid muscle active TrPs as compared to manual contact over the muscle tissues.
Detailed description
CeH pain has been mostly related to joint, disk and ligament pain from the upper cervical spine; however, clinicians should consider that the upper cervical spine also receives afferent inputs from muscles. In fact, the role of referred pain to the head elicited by muscle TrPs has received particular interest in recent years. No study has investigated the effectiveness of TrP manual therapy in patients with CeH exhibiting active TrPs. Investigators hypothesized that patients receiving a real TrP treatment will exhibit a greater reduction in pain, sensitivity, cervical range of motion and neck endurance than those receiving a manual control non-therapeutic intervention.
Interventions
OTHERTrP therapy
TrP manual therapy comprises different manual approaches, e.g., compression, stretching, or transverse friction massage applied over active TrPs in the sternocleidomastoid muscle
OTHERTrP manual control therapy
The treatment consisted of a simulation of the same TrP therapy treatment applied to the experimental group without the application of any therapeutic pressure.
Sponsors
University of Alcala
César Fernández-de-las-Peñas
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* unilateral pain starting in the neck and radiating to the frontal-temporal region * pain aggravated by neck movement * restricted cervical range of motion * joint tenderness in at least one of the joints of the upper cervical spine (C1-C3) * headache frequency of at least one per week over a period greater than 3 months * active TrPs in the sternocleidomastoid muscle
Exclusion criteria
* other primary headaches (i.e., migraine, tension type-headache) * bilateral headaches * had received treatment for neck or head pain in the previous year * presented any contraindications to manual therapy * had pending legal action regarding their neck and head pain.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in headache intensity from baseline to one week after treatment | Baseline and one week after the intervention | The intensity of head and neck pain was separately assessed with an 11-point numerical pain rate scale (NPRS, 0: no current pain, 10: maximum pain). It was recorded as a mean based on headaches experienced in the preceding week. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in cervical range of motion from baseline to one week after treatment | Baseline and one week after the intervention | Cervical range of motion was measured using a cervical range of motion (CROM) device. Subjects were asked to move their head as far as they could without pain in a stan¬dardized sequence: flexion, extension, affected/non-affected lateral flexion, and affected/non-affected rotation. |
| Change in pressure pain sensitivity from baseline to one week after treatment | Baseline and one week after the intervention | Pressure pain thresholds (PPT), i.e., the amount of pressure where a sensation of pressure first changes to pain was assessed with an analogical algometer over C0-C1, C1-C2 and C2-C3 zygapophyseal joints on the symptomatic side. |
| Change in deep cervical flexors motor performance from baseline to one week after treatment | Baseline and one week after the intervention | The motor performance of the deep cervical flexor muscles was tested in all patients by using the cervical flexor test (CCFT). |
Countries
Spain
Outcome results
None listed