Trigger Point Therapy in Cervicogenic Headache

MANUAL TREATMENT OF ACTIVE TRIGGER POINTS IN THE STERNOCLEIDOMASTOID MUSCLE IN PATIENTS WITH CERVICOGENIC HEADACHE: A PILOT RANDOMIZED CLINICAL TRIAL

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.

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.

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.