Trigger Point Therapy in Cervicogenic Headache

Not Applicable

Completed

• Conditions: Cervicogenic Headache
• Interventions: Other: TrP therapy; Other: TrP manual control therapy

• Registration Number: NCT01790074
• Lead Sponsor: César Fernández-de-las-Peñas

Brief Summary

It is a pilot randomized controlled trial comparing real and simulated manual treatment of trigger points (TrPs) in patients with cervicogenic headache (CeH). The purpose of the current randomized clinical pilot trial was to determine the preliminary effects of TrP manual therapy in individuals with CeH with sternocleidomastoid muscle active TrPs as compared to manual contact over the muscle tissues.

Detailed Description

CeH pain has been mostly related to joint, disk and ligament pain from the upper cervical spine; however, clinicians should consider that the upper cervical spine also receives afferent inputs from muscles. In fact, the role of referred pain to the head elicited by muscle TrPs has received particular interest in recent years. No study has investigated the effectiveness of TrP manual therapy in patients with CeH exhibiting active TrPs. Investigators hypothesized that patients receiving a real TrP treatment will exhibit a greater reduction in pain, sensitivity, cervical range of motion and neck endurance than those receiving a manual control non-therapeutic intervention.

Study Timeline

• Study Start: 2010-10
• Primary Completion: 2011-12
• Study Completion: 2011-12
• Status Verified: 2013-02
• Study First Submitted: 2013-02-09
• Study First Submitted QC: 2013-02-12
• Last Update Submitted: 2013-02-12
• Study First Posted: 2013-02-13
• Last Update Posted: 2013-02-13

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• unilateral pain starting in the neck and radiating to the frontal-temporal region
• pain aggravated by neck movement
• restricted cervical range of motion
• joint tenderness in at least one of the joints of the upper cervical spine (C1-C3)
• headache frequency of at least one per week over a period greater than 3 months
• active TrPs in the sternocleidomastoid muscle

Exclusion Criteria

• other primary headaches (i.e., migraine, tension type-headache)
• bilateral headaches
• had received treatment for neck or head pain in the previous year
• presented any contraindications to manual therapy
• had pending legal action regarding their neck and head pain.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
TrP therapy	TrP therapy	TrP manual therapy comprises different manual approaches, e.g., compression, stretching, or transverse friction massage applied over active TrPs in the sternocleidomastoid muscle
TrP manual control therapy	TrP manual control therapy	The treatment consisted of a simulation of the same TrP therapy treatment applied to the experimental group without the application of any therapeutic pressure.

Primary Outcome Measures

Name	Time	Method
Change in headache intensity from baseline to one week after treatment	Baseline and one week after the intervention	The intensity of head and neck pain was separately assessed with an 11-point numerical pain rate scale (NPRS, 0: no current pain, 10: maximum pain). It was recorded as a mean based on headaches experienced in the preceding week.

Secondary Outcome Measures

Name	Time	Method
Change in cervical range of motion from baseline to one week after treatment	Baseline and one week after the intervention	Cervical range of motion was measured using a cervical range of motion (CROM) device. Subjects were asked to move their head as far as they could without pain in a stan¬dardized sequence: flexion, extension, affected/non-affected lateral flexion, and affected/non-affected rotation.
Change in pressure pain sensitivity from baseline to one week after treatment	Baseline and one week after the intervention	Pressure pain thresholds (PPT), i.e., the amount of pressure where a sensation of pressure first changes to pain was assessed with an analogical algometer over C0-C1, C1-C2 and C2-C3 zygapophyseal joints on the symptomatic side.
Change in deep cervical flexors motor performance from baseline to one week after treatment	Baseline and one week after the intervention	The motor performance of the deep cervical flexor muscles was tested in all patients by using the cervical flexor test (CCFT).

Trial Locations

Locations (1)

University of Alcala; 🇪🇸 Alcala de Henares, Madrid, Spain