Impact of Posterior Chain Myofascial Release on Pain intensity, Pain threshold, Quality of life in Sinus Headaches: A Pre-Post Experimental Study

Sinus headache is a common facial pain issue, often misdiagnosed as migraines or sinusitis. It is an inflammatory process of the nasal mucosa and can be classified as acute (ARS) or chronic (CRS). The paranasal sinuses are made up of the ethmoid, maxillary, and sphenoid diverticula. Common symptoms include neck pain and facial heaviness, nasal congestion, pressure in the cheeks, and decreased sense of smell.

The International Classification of Headache Disorders (ICHD-3) diagnoses sinus headaches based on clinical, nasal endoscopic, and imaging evidence of acute rhinosinusitis. The majority of patients with sinus headaches actually have migraines. Other causes include cluster headaches, Sluder’s neuralgia, trigeminal neuralgia, myofascial trigger point pain, and contact point headaches.

Establishing whether neck pain is a localized cause related to cervical muscular dysfunction or if it is a component of the sinus headache symptom complex is crucial for diagnosis and therapy planning. Posterior Chain Myofascial Release (MFR) has been shown to have positive effects on mental health by reducing stress and anxiety levels.

This study aims to determine the effect of MFR in individuals with sinus headaches using the Numerical Pain Rating Scale, Pain threshold using a Pressure algometer, and Quality of life using the Sino-Nasal Outcome Test (SNOT-22). The hypothesis is either no change in the effect of MFR on pain intensity, pain threshold, or quality of life in sinus headaches.

This study focuses on sinus headaches in subjects aged 20-55 years. The study design is an experimental study with a sample size of 40.The study includes all gender subjects diagnosed with sinus headaches, those within 20-55 years of age, and those with primary headaches, autonomic system symptoms, or conditions that might contraindicate MFR technique in posterior chain regions.

The study uses a numerical pain rating scale (NPRS) and pressure algometer to assess pain intensity and quality of life. The NPRS is a self-reported or clinician-administered measurement scale with extreme anchors ranging from 0-10 to 100. The pressure algometer calculates the pressure pain threshold (PPT) throughout a 4-point range. The SNOT-22 is a valid and reliable tool with a reliability coefficient of 0.93.

Following up assessment, patients will be followed by telephone after completing all five treatment sessions within a month and reassessed based on the outcomes i.e. NPRS and SNOT-22.

Participant’s selection will be done as per the Inclusion and exclusion criteria. The purpose of the study will be explained to the participants. A written informed consent will be obtained from the participants. A brief demographic data will be obtained from the subjects prior to the assessment. Baseline assessment of the participants will be done before the intervention. Then the participants will be given Myofascial release. Post- intervention data will be collected and analyzed.

INTERVENTION

Manual method of Myofascial release will be done for thoraco- lumbar fascia, erecter spinae muscle, hamstring muscle, calf muscle, sub-occipital muscles, frontal sinus and maxillary sinus. Subjects will  receive three sets of the release with a 60-second hold, on alternate days for two weeks. A total sessions will be conducted. You will receive education on dietary guidelines, including recommended practices and what to avoid, and will be advised to use steam.