Headache Research

Have a bad headache?

Have you been experiencing headaches increased from neck movement or associated with tenderness in the neck musculature? Are headaches interfering with your enjoyment of life?
Because of our effectiveness in the treatment of cervicogenic headaches Therapeutic Rehab Specialists has conducted an innovative University research study on various therapeutic techniques in decreasing symptoms of headaches related to (the cervical spine) neck dysfunction.
In this study we have demonstrated significant evidence in relieving and reducing occurrences of cervicogenic headaches through physical therapy manual therapeutic techniques. We can even show you how to treat your own headaches.

Call Therapeutic Rehab Specialists at (813) 876-8771 or (727) 470-6070 and ask for Anthony Pribila, PT, DSc, CMPT, CMP, CEAS, or Brad Young, PT, CEAS to find out if we can help you start living headache free.
You can e-mail us at trehabspecialist@aol.com


   
ANTHONY PRIBILA, PT* • LEE OLSEN, PT, DC*
JASON W. BECKSTEAD, Ph.D.*

Is Mobilization of the Cervical Spine Effective in Decreasing Symptoms of Cervicogenic Headache?

STUDY DESIGN: Randomized, double blind placebo controlled trial.


OBJECTIVES: To determine the effectiveness of mobilization of the cervical spine on reducing cervicogenic headache.


BACKGROUND: Cervicogenic headaches are commonly occurring symptoms of neck pain. An effective form of treatment would be beneficial to the field of Physical Therapy in providing patients with lasting pain relief. The purpose of this study is to determine if the inclusion of mobilization of the cervical spine is more effective in decreasing cervicogenic headaches compared to treatment without mobilization and non-treatment. Determining a correlation between dominant sided cervicogenic headaches and range of motion restrictions could improve physical therapy assessment and treatment outcomes.


METHODS: Through purposive sampling, 25 symptomatic subjects ages 24-65 with cervicogenic headaches were randomized into a mobilization, a traditional and a non-treatment group. Study inclusion was based upon subjects headache symptoms attributed to: tightness of the neck musculature, resistance to or limitation of neck movement, and headaches provoked by neck movement or positioning. Range of motion for lower or planar cervical rotation and upper cervical rotation using a flexion-rotation test (FRT) was goniometrically measured. The ‘traditional treatment’ group, was treated with modalities and therapeutic exercise based upon signs and symptoms.
The mobilization group included ‘traditional treatment’ with the addition of cervical spine mobilization. The control group received no physical therapy intervention. Pain levels were measured throughout the study’s 8 week period using a visual analog scale (VAS).
A Northwick Park Pain Questionnaire (NWPPQ) was used to determine the client’s perceived functional disability. Headache frequency was recorded daily using a headache log sheet. Upper cervical rotation range of motion was recorded using goniometric measurements by the same examiner. Data recorded throughout the study was compared between the three groups.


RESULTS: Of the 25 subjects with cervicogenic headaches 15 complained of bilateral headaches, 3 with right sided headaches and 7 with left sided headaches. The C ½ region was deemed to be the main contributor of cervicogenic headaches in (72%) of the 25 individuals. The C 2/3 regions was found as the main contributor in (24%), and the C 0/1 region in (4%).
The individuals in the mobilization group demonstrated less overall pain than the traditional and control groups (P < .001). The mobilization group also demonstrated lower scores (mean + or – SD, 6 + or – 6) on the (NWPPQ) than traditional (mean + or – SD, 11 + or – 6) and control group (mean + or – SD, 12 + or – 8). Although the mobilization group demonstrated a 50% decrease in perceived disability since initial visit, this was not found to be statistically significant (P >.001). A one way analysis of variance (ANOVA) for repeated measures of headache frequency was found to be less frequent and more statistically significant in the mobilization group (P = .041) compared to the traditional (P=.076) and control group (P=.356).
The traditional and mobilization group demonstrated greater increases in planar cervical rotation than the control group. The mobilization group demonstrated the highest achievement of cervical rotation with a mean of (85° + or -5.2°.)
The flexion rotation test (FRT) range of motion demonstrated the most improvement in the traditional group with a mean improvement of 16° in left upper cervical mobility with a 12° increase in right upper cervical rotation. The mobilization group demonstrated a mean increase of 10° for left rotation and 14° for right rotation.


CONCLUSIONS: The findings suggests the inclusion of cervical spine mobilization to traditional physical therapy treatment; specifically the C ½ segmental level; was more effective in reducing frequency and intensity of cervicogenic headaches, while increasing planar range of motion and overall function. It also demonstrated no association between specific dominant sided headaches and range of motion restrictions.
  
Click here to read the full report.