Comparative Effects of Back School Based Intervention Versus Cranio-Cervical Muscle Training in Computer Users With Cervicogenic Headache

Effects of Back School Based Intervention Versus Cranio-Cervical Muscle Training on Pain, Posture and Disability in Computer Users With Cervicogenic Headache

The aim of the study is to compare Back School Based Intervention with Cranio- Cervical muscle training in participants with Cervicogenic headache. The study wants to investigate that which intervention helps to mange pain, improve posture and reduce disability. The study aims to answer the question:

• How effective is Back School Based intervention on pain, posture and disability in computer users with Cervicogenic headache compared to Cranio-cervical Muscle Training? Participants will
• Attend the treatment sessions of the group in which they are placed.
• Take treatment session two times a week for eight weeks.
• Participants will be asked about their pain and activities throughout the study.

• Headache is one of the disorder that affects 50% of the population worldwide which have negative impact on the quality of life. Cervicogenic headache is the secondary type of headache in which the pain referred from the cervical spine. Headache aggravates by the neck movement and significant reduced range of motion is noticed among patients.
• The management of the cervicogenic headache is both pharmacological and non- pharmacological but pharmacological having more side effects.Non pharmacological management includes massage, dry needing, physical therapy exercises, manual therapy and patient education.
• Cranio-cervical muscle training include cranio-cervical flexion exercises, strengthening, stretching, posture exercises and cervical stabilization exercises. These exercises altogether helps in the strengthening of the neck and shoulder muscles which ultimately correct the cervical impairment which neutralize the posture and decrease the load on the structures of the spine.
• Back school based exercise program can have both practical and theoretical sessions. In practical part patient is guided to the different strengthening and flexibility exercises with increase resistance in each session. In theoretical part patient education is the main part. Patient is educated about the anatomical and posture related changes in the spine so he/ she can identify and correct them by incorporating in their daily life.

Inclusion Criteria:

• Participants of both gender.
• Participants aged between 19 to 44 years.
• Participants having unilateral headache without side shift for>3 months aggravated by neck movement.
• Participants with pain intensity ≥3 on a visual analog scale (VAS).
• Participants working on the computer for an average 32 h per week.
• Participants having positive cervical flexion rotation test (CFRT).
• Participants having joint tenderness in at least one of the upper three cervical joints with palpation.

Exclusion Criteria:

• If participants having any history of fractures or previous surgery of the vertebral column, any degenerative and inflammatory arthritis, osteoporosis, dislocations, cervical radiculopathy/myelopathy and any history of whiplash injury.
• Participants showing any signs of the five 'D's' or three 'N's.