Effectiveness of Dry Needling of the Sternocleidomastoid in Patients With Cervicogenic Headaches

Study Overview
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Brief Summary
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Evaluating the benefit of dry needling of the sternocleidomastoid muscle in subjects with cervicogenic headaches.

Detailed Description
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The purpose of this study is to determine whether individuals with cervicogenic headache respond favorably to a program of manual therapy in combination with dry needling of the major muscle between chest bone and the head (sternocleidomastoid muscle) compared to manual therapy directed to the upper body quadrant alone. The researchers will conduct a randomized clinical trial to assess the effectiveness of a manual therapy and dry needling approach (group 1) vs. manual therapy only. (group 2)

Official Title
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Effectiveness of Dry Needling of the Sternocleidomastoid in Patients With Cervicogenic Headaches - A Randomized Clinical Trial

Conditions
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Cervicogenic Headache

Intervention / Treatment
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* Procedure: Dry needling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 18-65 years old Primary complaint of cervicogenic headache Restricted cervical Range of motion Neck Disability Index > 20 points Exclusion Criteria: Red flags identified during the patients physical therapy initial evaluation (i.e. tumor, fracture, metabolic diseases, RA, osteoporosis, prolonged history of steroid use, symptoms of vertebrobasilary insufficiency, pregnancy, cervical spinal stenosis, bilateral upper extremity symptoms etc. Use of blood thinners History of whiplash injury within the past six weeks Evidence of central nervous system involvement, to include hyperreflexia, sensory disturbances in the hand, intrinsic muscle wasting of the hands, unsteadiness during walking, nystagmus, loss of visual acuity, impaired sensation of the face, altered taste, the presence of pathological reflexes (i.e. positive Hoffman's and/or Babinski reflexes), etc. Two or more positive neurologic signs consistent with nerve root compression, including any two of the following: Muscle weakness involving a major muscle group of the upper extremity Diminished upper extremity muscle stretch reflex (biceps brachii, brachioradialis, or triceps) Diminished or absent sensation to pinprick in any upper extremity dermatome Prior surgery to the neck or thoracic spine Chiropractic, Physical Therapy, or Acupuncture treatment for their neck pain in the last 6-months Workers compensation or pending legal action regarding their headaches Insufficient English language skills to complete all questionnaires Inability to comply with treatment and follow-up schedule

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: standard care group<br>Normal manual therapy interventions Clinician will decide normal course of treatment | |
| Experimental: Dry needling<br>Dryneedling group Clinician will decide normal course of treatment and dry needling of the Sternocleidomastoid muscle (SCM) muscle will be added to that treatment | Procedure: Dry needling<br>* Dryneedling of the sternocleidomastoid muscles within a standard treatment approach of physical therapy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Headache Disability Index (HDI) score | Questionnaire for self report, this will be on a 0-100 score | At initial evaluation (day 1), week three (day 21) and week 6 (day 42) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in cervical range of motion using an inclinometer/ change in high cervical range of motion using the Flexion-Rotation Test (FRT) | range of motion assessment, this will be measured in degrees with standardized goniometer measure | At initial evaluation (day 1), week three (day 21) and week 6 (day 42) | 
| Change in the neck disability Index score | Self report neck pain questionnaire, This is a 0-100 score | At initial evaluation (day 1), week three (day 21) and week 6 (day 42) | 
| Change in visual analogue scale score | Pain intensity scale,on a 10 cm line patient is asked to mark pain with one vertical mark | At initial evaluation (day 1), week three (day 21) and week 6 (day 42) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dry needling, Cervicogenic headache, Manual therapy