Effects of Sub-Occipital Myofascial Release in Patients With Cervicogenic Headache
Condition: Cervicogenic Headache
MeSH terms: Post-Traumatic Headache; Headache
Study type: Interventional

Summary: 
      Cervicogenic headache is a secondary form of headache that occurs from the upper cervical
      spine and atlanto-occipital joint. A CGH is a frequent source of chronic headache and is
      frequently misdiagnosed .Cervicogenic headache is among the most common problem affecting
      four times more women as compared to males and is considered by some painful feeling in the
      head , neck ,temporal area, frontal area and around the eyes areas.
    

Detailed description: 
      There is also pain in the face and ipsilateral head that does not alternate the sides, but
      when cervicogenic headache becomes severe, in some patients pain may occasionally feel it on
      the other side of the head. Diagnosis of cervicogenic headache depends on the detailed
      patient's history, manual examination and the assessment of nervous system. After the
      diagnostic block test disappearance of headache shows that the source of this pain is
      cervical spine. Cervical flexion rotation test is a very useful diagnostic measure in
      cervical movement restriction and differential diagnosis of cervicogenic headache. Physical
      therapy is considered most effective treatment of cervicogenic headache in which different
      techniques manipulative therapy, mobilization of cervical vertebrae, stretches and
      sub-occipital myofascial release used.

      Objective: To determine the effects of sub-occipital myofascial release in patients with
      cervicogenic headache.

      Methods: This study was randomized control trial and on the basis of inclusion criteria, 22
      patients were included and were randomized through sealed envelope in two groups A and B.
      Group A was given sub-occipital myofascial release along with conventional therapy while
      group B was given cervical mobilization and conventional therapy and both groups were
      assessed by using Neck Disability Index(NDI), Pain Numerical Rating Scale(PNRS) and cervical
      range of motion by goniometer at baseline, Week(1-4) and 8th week( last week) .The data was
      analyzed using SPSS 21.
    

Intervention name(s): cervical mobilization (Headache SNAG); Sub-occipital myofascial release
Intervention type(s): Other; Other
Intervention description(s): For cervical mobilization the patient's position is sitting on a chair in the erect posture. The therapist handled C2 spinous process with the middle phalanx of one hand. With the other hand, he performed ventral glide asked the patient to move neck in all directions (Flexion, Extension, Side bending and rotation) one by one and then slowly move the neck back to its starting position while the therapist maintained the ventral glide.; For the application of the technique , the patient position is supine lying with the head fully supported on therapist's hands and therapist places 3 middle fingers just inferior to the nuchal line, lifts the fingers tips towards the ceiling while resting the head on the table and then therapist will apply a gentle upward pull. This procedure done for 2 to 3 minutes and 5 to 7 repetitions, 3 sessions per week on alternate days were given for 6 weeks.
Evaluation was done before treatment, during treatment at 4th week and after treatment at 6th week. Outcomes will be measured by NDI, PNRS and Universal Goniometer.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cervicogenic headache; Pain Numerical Rating Scale; Neck disability index