Dry Needling Versus Instrumented Assisted Soft Tissue Mobilization In the Patient With Cervicogenic Treatment Headache

Dry Needling Versus Instrumented Assisted Soft Tissue Mobilization In the Patient With Cervicogenic Treatment Headache; Randomized Controlled Trial

the aim of this study is to investigate the efficacy of Dry Needling Versus Instrumented Assisted Soft Tissue Mobilization In the Patient With Cervicogenic Treatment Headache

Cervicogenic headache has been classified as a secondary type headache, and it is usually associated with cervical myofascial pain sources as myofascial trigger points . It also could be related to any joint, disc, and ligament disease of the upper region of the neck.physiotherapist use trigger point dry needling as an invasive treatment for CGH where a solid filament needle is inserted into a myofascial trigger point . The advantages of Dry needling are increasingly documented .Instrument-assisted soft tissue mobilization technique has been reported to decrease pain, improve overall function, and increase range of motion . It enhances the ability of physical therapists to detect altered tissue properties, through the vibration sense within the instrument, and to treat soft tissue dysfunction. It also enhances the patient's awareness of altered sensations within the treated tissues.

Inclusion Criteria:

• 20 to 60 years old patient with unilaterally of the head pain
• pain triggered by external pressure over the upper cervical joints (c1-c3)
• pain elicited by the neck movements, and/or sustained awkward positions with reduced neck ROM
• headache intensity pain score of at least 20mm on the Visual analogue scale (VAS)
• headache frequency of at least once a week for at least 3 months
• minimum neck disability index score of 10 points or greater

Exclusion Criteria:

• Migraine, tension- type headache, tumor, osteoporosis, fracture, rheumatoid arthritis and metabolic diseases.
• Prolonged history of steroid use.
• Resting blood pressure greater than 140/90 mmhg.
• cervical spinal stenosis, diminished sensation and central nervous system involvement,
• previous head or neck surgery or whiplash injury history within the last 6 weeks