Clinical trial NCT04816448: Effects of Sub-Occipital Myofascial Release in Patients With Cervicogenic Headache
Official title: Effects of Sub-Occipital Myofascial Release in Patients With Cervicogenic Headache
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Cervicogenic Headache
Keywords: Cervicogenic headache
Pain Numerical Rating Scale
Neck disability index
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2021-03-25
Enrollment: 22
Sex: ALL
Minimum age (years): 20
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief 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.

Eligibility criteria: Inclusion Criteria:

* • Both Genders

  * Age between 20 to 75 Years
  * Neck pain referring the unilateral pain to the sub-occipital region and head.
  * Headache intensifying upon manual pressure to upper cervical joints and muscles
  * With the cranio-cervical Flexion rotation exam, neck pain and ipsilateral headache and restriction of C1 and C2 rotation.

Exclusion Criteria:

* • Tension headache (Headache on both sides)

  * If the patient not tolerate the cranio-cervical Flexion rotation test.
  * Patients presents with autonomic symptoms like visual disturbance, vertigo, dizziness.
  * If the physiotherapeutic modalities used for head pain in the last 6 months.
  * Headache other than cervical origins.
  * Clinically diagnosed as case of cervical radiculopathy or myelopathy.
  * Extreme cervical discomfort due to disk herniation, stenosis of the spinal canal and cervical arthritis.
  * Each other disorder that may be contraindicated in the upper cervical area of myofascial release.

Primary outcomes:
measure: Pain Numeric Rating Scale
timeFrame: 4 months
measure: NECK DISABILITY INDEX
timeFrame: 4 months
Secondary outcomes:
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: Riphah Rehabilitation Center
state: Punjab
Study officials:
affiliation: Riphah International University
name: Maryam Shabbir, MS
role: PRINCIPAL_INVESTIGATOR
References:
citation: Singh LR, Chauhan V. Comparison of efficacy of myofascial release and positional release therapy in tension type headache. JMSCR. 2014;2(9):2372-9.
citation: Racicki S, Gerwin S, Diclaudio S, Reinmann S, Donaldson M. Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. J Man Manip Ther. 2013 May;21(2):113-24. doi: 10.1179/2042618612Y.0000000025.
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citation: Bovim G, Berg R, Dale LG. Cervicogenic headache: anesthetic blockades of cervical nerves (C2-C5) and facet joint (C2/C3). Pain. 1992 Jun;49(3):315-320. doi: 10.1016/0304-3959(92)90237-6.