Published in Neurology
Journal Scan / Review · April 17, 2022
TAKE-HOME MESSAGE
- This systematic review identified manual therapy options for cervicogenic headache and assessed their effectiveness. A total of 14 articles were ultimately included which investigated seven different manual therapy techniques as well as the use of home acupuncture pillows. Spinal manipulative therapy, which acts on specific subluxations, and the use of corrective movements during weight-bearing tasks (a technique called Mulligan’s sustained natural apophyseal glides) were identified as the most effective treatment options in reducing the frequency and intensity of headaches and perceived disability. Several of the cited studies identified therapies that reduced headache intensity up to 1 year after treatment after as few as 6 sessions.
- This review highlights several treatments that are effective for managing cervicogenic headache, which may be helpful to providers working with physical therapists to develop maximally effective care plans for their patients. It further reinforces the importance of counseling patients on the treatability of their headache with manual therapy rather than at-home methods alone.– Meredith Bowen, MD
Abstract
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.