Effects of manual therapy on cervicogenic headaches: a therapeutic approach
DOI:
https://doi.org/10.5935/0104-7795.20140012Keywords:
Headache Disorders, Combined Modality Therapy, Musculoskeletal Manipulations, Physical Therapy ModalitiesAbstract
The cervical spine is considered a possible source of headaches, however there are still some controversies regarding the pathophysiology, clinical presentation, and treatment. Objective: To propose a physical therapy treatment protocol with multimodal approach for cervicogenic headache and evaluate the effects of manual therapy on such patients. Method: This was an uncontrolled experimental study in which 9 patients from the UNIFESO Physical Therapy Clinic (Teresópolis, RJ) diagnosed with cervicogenic headache underwent 10 physiotherapy interventions with manual therapy techniques. The experimental protocol included joint techniques, fascial release, and muscle recruitment. The Neck Disability Index (NDI) and a visual analogic scale (VAS) were used as measurement tools and the pain pattern was recorded. Results: Of the nine selected patients, all were female and had an average age of 43.3 years (± 15.5). Significant differences were observed between the average intensity of pain (VAS) before treatment (8.0 ± 1.3) and after (2.2 ± 0.9, p < 0.01). The NDI also showed improvement after intervention 63.9% (p < 0.01). Regarding crises frequency, a decrease of 70% was observed after the intervention (p < 0.01) and a reduction was also shown in the duration of such crises before (4 hours ± 1.5) and after treatment (1 hour ± 0.5; p < 0.01). Conclusion: A multimodal approach by manual therapy techniques was beneficial in the reduction of the patients’ symptoms and it provided a decrease in cervical disability.
Downloads
References
Vincent MB. Cervicogenic headache: clinical aspects. Clin Exp Rheumatol. 2000;18(2 Suppl 19):S7-10.
Silva Júnior AA, Moraes DN, Rezende FB, Pereira GL, Morato EG, Cunninghan MCQS, et al. Frequência dos tipos de cefaleias atendidos no pronto atendimento do Hospital das Clínicas da Universidade Federal de Minas Gerais. Migrâneas Cefaleias. 2008;11(2):67-72.
Rachid RM, Pinheiro LTM. A terapia osteopática manipulativa na cefaléia cervicogênica. RBPS. 2009;22(2):128-34.
Bono G, Antonaci F, Dario A, Clerici AM, Ghirmai S, Nappi G. Unilateral headaches and their relationship with cervicogenic headache. Clin Exp Rheumatol. 2000;18(2 Suppl 19):S11-5.
Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia. 1988;8 Suppl 7:1-96.
Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. Headache. 1990;30(11):725-6. DOI: http://dx.doi.org/10.1111/j.1526-4610.1990.hed3011725.x
Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. The Cervicogenic Headache International Study Group. Headache. 1998;38(6):442-5. DOI: http://dx.doi.org/10.1046/j.1526-4610.1998.3806442.x
Cleland JA, Fritz JM, Whitman JM, Palmer JA. The reliability and construct validity of the Neck Disability Index and patient specific functional scale in patients with cervical radiculopathy. Spine (Phila Pa 1976). 2006;31(5):598-602. DOI: http://dx.doi.org/10.1097/01.brs.0000201241.90914.22
Cook C, Richardson JK, Braga L, Menezes A, Soler X, Kume P, et al. Cross-cultural adaptation and validation of the Brazilian Portuguese version of the Neck Disability Index and Neck Pain and Disability Scale. Spine (Phila Pa 1976). 2006;31(14):1621-7. DOI: http://dx.doi.org/10.1097/01.brs.0000221989.53069.16
Kisner C, Colby LA. Exercícios terapêuticos: fundamentos e técnicas. 4 ed. São Paulo: Manole; 2005.
Chaitow L. Técnicas avanzadas para tejido blando-técnicas de liberación posicional. 3 ed. Madrid: Elsevier; 2009.
D'ambrogio KJ, Roth GB. Terapia de liberação posicional. São Paulo: Manole; 2001.
Maitland GD, Hengeveld E, Banks K, English K. Manipulação vertebral de Maitland. 6 ed. Rio de Janeiro: MEDSI; 2003.
Jull GA, O'Leary SP, Falla DL. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther. 2008;31(7):525-33. DOI: http://dx.doi.org/10.1016/j.jmpt.2008.08.003
Knackstedt H, Bansevicius D, Aaseth K, Grande RB, Lundqvist C, Russell MB. Cervicogenic headache in the general population: the Akershus study of chronic headache. Cephalalgia. 2010;30(12):1468-76. DOI: http://dx.doi.org/10.1177/0333102410368442
Miller J, Gross A, D'Sylva J, Burnie SJ, Goldsmith CH, Graham N, et al. Manual therapy and exercise for neck pain: a systematic review. Man Ther. 2010;15(4):334-54. DOI: http://dx.doi.org/10.1016/j.math.2010.02.007
Gross AR, Hoving JL, Haines TA, Goldsmith CH, Kay T, Aker P, et al. A Cochrane review of manipulation and mobilization for mechanical neck disorders. Spine (Phila Pa 1976). 2004;29(14):1541-8. DOI: http://dx.doi.org/10.1097/01.BRS.0000131218.35875.ED
van Duijn J, van Duijn AJ, Nitsch W. Orthopaedic manual physical therapy including thrust manipulation and exercise in the management of a patient with cervicogenic headache: a case report. J Man Manip Ther. 2007;15(1):10-24. DOI: http://dx.doi.org/10.1179/106698107791090114
Nogueira LAC. Neurofisiologia da terapia manual. Fisioter Brasil. 2008; 9(6):414:21.
Jull G, Amiri M, Bullock-Saxton J, Darnell R, Lander C. Cervical musculoskeletal impairment in frequent intermittent headache. Part 1: Subjects with single headaches. Cephalalgia. 2007;27(7):793-802. DOI: http://dx.doi.org/10.1111/j.1468-2982.2007.01345.x
Rudolfsson T, Björklund M, Djupsjöbacka M. Range of motion in the upper and lower cervical spine in people with chronic neck pain. Man Ther. 2012;17(1):53-9. DOI: http://dx.doi.org/10.1016/j.math.2011.08.007
Fryer G, Hodgson L. The effect of manual pressure release on myofascial trigger points in the upper trapezius muscle. J Bodyw Mov Ther. 2005;9(4):248-55. DOI: http://dx.doi.org/10.1016/j.jbmt.2005.02.002
Bodes-Pardo G, Pecos-Martín D, Gallego-Izquierdo T, Salom-Moreno J, Fernández-de-Las-Peñas C, Ortega-Santiago R. Manual treatment for cervicogenic headache and active trigger point in the sternocleidomastoid muscle: a pilot randomized clinical trial. J Manipulative Physiol Ther. 2013;36(7):403-11. DOI: http://dx.doi.org/10.1016/j.jmpt.2013.05.022
Wand BM, Keeves J, Bourgoin C, George PJ, Smith AJ, O'Connell NE, et al. Mislocalization of sensory information in people with chronic low back pain: a preliminary investigation. Clin J Pain. 2013;29(8):737-43. DOI: http://dx.doi.org/10.1097/AJP.0b013e318274b320
Lin YC, Lai CH, Chang WH, Tu LW, Lin JC, Chou SW. Immediate effects of ischemic compression on neck function in patients with cervicogenic cephalic syndrome. J Manipulative Physiol Ther. 2012;35(4):301-7. DOI: http://dx.doi.org/10.1016/j.jmpt.2012.04.009
Grande RB, Aaseth K, Benth JŠ, Lundqvist C, Russell MB. Reduction in medication-overuse headache after short information. The Akershus study of chronic headache. Eur J Neurol. 2011;18(1):129-37. DOI: http://dx.doi.org/10.1111/j.1468-1331.2010.03094.x
Chaibi A, Russell MB. Manual therapies for cervicogenic headache: a systematic review. J Headache Pain. 2012;13(5):351-9. DOI: http://dx.doi.org/10.1007/s10194-012-0436-7
Downloads
Published
Issue
Section
License
Copyright (c) 2014 Acta Fisiátrica
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
