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AI-Generated response:

What are the most effective manual therapy interventions for treatment of a cervicogenic headache

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

The most effective manual therapy interventions for the treatment of cervicogenic headache include spinal manipulative therapy, Mulligan's Sustained Natural Apophyseal Glides, muscle techniques, and translatory vertebral mobilization.[1]

It is important to note that while these therapies can be effective, the evidence is not robust due to methodological limitations such as small sample sizes and the inclusion of quasi-experimental studies.[1]

  • Spinal manipulative therapy has shown short-term benefits in reducing pain intensity and frequency in cervicogenic headache.[2]

  • Mulligan's Sustained Natural Apophyseal Glides and translatory vertebral mobilization are specific manual therapy techniques that have been studied for their effectiveness in treating cervicogenic headache.[1]

  • Muscle techniques, including the Jones technique on the trapezius and ischemic compression on the sternocleidomastoid, have demonstrated immediate improvements in symptoms.[1]

  • The combined use of different manual therapy techniques has been suggested to improve outcomes compared to using a single technique alone.[1]

Additional info

The effectiveness of manual therapy for cervicogenic headache is supported by several studies, but the quality of evidence varies. For instance, a systematic review by Núñez-Cabaleiro and Leirós-Rodríguez highlights the potential of manual therapy but also points out the limitations due to the inclusion of quasi-experimental studies and small sample sizes, which may affect the generalizability of the results.[1] Another systematic review by Fernandez et al. supports the use of spinal manipulative therapy, noting significant short-term effects on pain intensity and frequency, although the long-term benefits are less clear.[2] These findings suggest that while manual therapy can be a valuable part of a multidisciplinary approach to managing cervicogenic headache, further high-quality research is needed to fully establish its efficacy and optimize treatment protocols.

References

Reference 1

1.

Núñez-Cabaleiro P, Leirós-Rodríguez R. Headache. 2022;62(3):271-283. doi:10.1111/head.14278.

Publish date: March 2, 2022.

OBJECTIVE: The aim of this study was to identify the manual therapy (MT) methods and techniques that have been evaluated for the treatment of cervicogenic headache (CH) and their effectiveness. BACKGROUND: MT seems to be one of the options with the greatest potential for the treatment of CH, but the techniques to be applied are varied and there is no consensus on which are the most indicated. METHODS: A systematic search in Scopus, Medline, PubMed, Cinahl, PEDro, and Web of Science with the terms: secondary headache disorders, physical therapy modalities, musculoskeletal manipulations, cervicogenic headache, manual therapy, and physical therapy. We included articles published from 2015 to the present that studied interventions with MT techniques in patients with CH. Two reviewers independently screened 365 articles for demographic information, characteristics of study design, study-specific intervention, and results. The Oxford 2011 Levels of Evidence and the Jadad scale were used. RESULTS: Of a total of 14 articles selected, 11 were randomized control trials and three were quasi-experimental studies. The techniques studied were: spinal manipulative therapy, Mulligan's Sustained Natural Apophyseal Glides, muscle techniques, and translatory vertebral mobilization. In the short-term, the Jones technique on the trapezius and ischemic compression on the sternocleidomastoid achieved immediate improvements, whereas adding spinal manipulative therapy to the treatment can maintain long-term results. CONCLUSIONS: The manual therapy techniques could be effective in the treatment of patients with CH. The combined use of MT techniques improved the results compared with using them separately. This review has methodological limitations, such as the inclusion of quasi-experimental studies and studies with small sample sizes that reduced the generalizability of the results obtained.

Reference 2

2.

Fernandez M, Moore C, Tan J, et al. European Journal of Pain (London, England). 2020;24(9):1687-1702. doi:10.1002/ejp.1632.

Publish date: October 4, 2020.

BACKGROUND: Spinal manipulative therapy (SMT) is frequently used to manage cervicogenic headache (CGHA). No meta-analysis has investigated the effectiveness of SMT exclusively for CGHA. OBJECTIVE: To evaluate the effectiveness of SMT for CGHA. DATABASES AND DATA TREATMENT: Five databases identified randomized controlled trials comparing SMT with other manual therapies. The PEDro scale assessed the risk-of-bias. Pain and disability data were extracted and converted to a common scale. A random effects model was used for several follow-up periods. GRADE described the quality of evidence. RESULTS: Seven trials were eligible. At short-term follow-up, there was a significant, small effect favouring SMT for pain intensity (mean difference [MD] -10.88 [95% CI, -17.94, -3.82]) and small effects for pain frequency (standardized mean difference [SMD] -0.35 [95% CI, -0.66, -0.04]). There was no effect for pain duration (SMD - 0.08 [95% CI, -0.47, 0.32]). There was a significant, small effect favouring SMT for disability (MD - 13.31 [95% CI, -18.07, -8.56]). At intermediate follow-up, there was no significant effects for pain intensity (MD - 9.77 [-24.21 to 4.68]) and a significant, small effect favouring SMT for pain frequency (SMD - 0.32 [-0.63 to - 0.00]).

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