Comparing the Effectiveness of Dry Needling and Ischemic Compression on Tension Type Headache
Condition: Tension-Type Headache
MeSH terms: Tension-Type Headache; Headache
Study type: Interventional

Summary: 
      Headaches are the main health problem as one of the prevalent type of all symptoms in the
      world population. Among different types of headaches, the most prevailing primary headache in
      general population is Tension-type headache (TTH). According to Global Burden Disease study
      conducted in 2016 tension-type headache ranks the third highest primary headache syndromes
      among 32 diseases and injuries in 195 countries from the Period of 1990 to 2016.These types
      of headaches are associated with significant reductions in productivity of an individual with
      prominent increase in socioeconomic costs. There are various treatments suggested for
      improving the symptoms in trigger point related tension type headaches such as usage of hot
      packs, cryotherapy, ultrasound therapy, mobilization and manipulation techniques, Dry
      needling, MET and ICT. None of the study has been conducted in Pakistan which has compared
      two specific techniques to resolve trigger points with the accuracy of diagnosis by
      diagnostic ultrasound in limited time period, which is cost friendly, and provides quick
      relief to patients without causing a lot of pain. Therefore, more studies are needed to
      overcome the gap area in the use of specific techniques in clinics with accurate diagnosis by
      the clinicians of Pakistan.
    

Detailed description: 
      The research aims to compare the effectiveness of Dry Needling and Ischemic Compression
      Technique on muscle thickness &amp; health related quality of life in trigger point related
      tension type headache. Headaches are the major health concern as one of the prevalent type of
      all symptoms in the worldwide population and are the cause of disabilities and hindrance in
      productivity of an individual.

      The treatment approaches performed for trigger point related tension type headache are
      non-specific, vigorous, time consuming and costly. It is due to the inaccurate location of
      the trigger points present in cervical musculature. The studies related to comparison of
      specific treatment procedures to treat trigger point related tension type headaches such as
      dry needling and Ischemic Compression technique with the knowledge of accurate location of
      trigger points present in cervical musculature are lacking in Pakistani population. Hence the
      current study is aimed to determine the effect of dry needling and Ischemic Compression
      technique with the use of diagnostic ultrasound on muscle thickness, pain and health related
      quality of life in Trigger point related tension type headache. The study will be conducted
      on the tension type headache diagnosed individuals aged 20 to 50 years of age, at Physical
      Therapy OPD of Saifee and Ziauddin Hospital with the help of envelope method as a
      randomization technique. Dry needling will be performed on Group A whereas Group B will be
      given Ischemic Compression technique on trigger points diagnosed by Musculoskeletal
      Ultrasound. Patient's headache, muscle thickness and health related quality of life will be
      assessed by Numeric Pain rating scale, Musculoskeletal Ultrasound and Short Form-36
      Questionnaire respectively. If the data will be found to be normally distributed, Pair T-test
      will be run for with the group analysis. Between the groups an alysis will be perform by
      Independent t test. In case data found to be deviated from the assumption of normal
      distribution, Paired T-test will be replaced by Wilcoxon test and Independent T test will be
      replaced by Mann Whitney U Test. The level of significance will be kept at 95% alpha-0.05.
    

Intervention name(s): Dry Needling and Ischemic Compression Technique
Intervention type(s): Other
Intervention description(s): For Group A, Dry needling will be applied into trigger points which are active and present in the muscles, efficiently and within the safe limits taking all the safety precautions.
For group B, Ischemic Compression Technique will be applied on trigger points.
The complete treatment session will be comprised of 3 sessions per week for two weeks followed by follow up after 1 month until the symptoms have been improved for both the groups.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Group A: Dry Needling treatment given for 6 sessions, 3 days/week for 2 weeks on the trigger points located in Upper Trapezius, Sternocleidomastoid, Sub occipitalis and Temporalis muscles.
Group B:
Ischemic Compression technique given for 6 sessions, 3 days/week for 2 weeks on the trigger points located in Upper Trapezius, Sternocleidomastoid, Sub occipitalis and Temporalis muscles.
Masking: Single (Participant)
Primary purpose: Supportive Care