Cervicogenic headache (CBH) is defined as a headache caused by a disorder in the cervical spine, bones, discs, or soft tissue elements, which is also accompanied by neck pain.
Unilateral, non-reversible oculo, fronto, temporal pain, pain that increases with poor neck positioning and incorrect neck movements, and may be seen with restricted movement in the upper cervical and occiput regions.
The aim of this thesis is to compare the effectiveness of Mulligan mobilization technique and myofascial release methods used in the treatment of cervicogenic headache through a prospective clinical study.
Individuals aged 18-65
Having experienced neck or headache for 3 months
Meeting the diagnostic criteria for cervicogenic headache;
Unilateral pain
Migraine
Cluster headache
Cervical radiculopathy
Entrapment neuropathy
Parallel
Mulligan mobilization therapy
Other interventionEach patient was asked to sit comfortably, and the therapist performing the treatment stood beside them. The patient's head was free and positioned between the therapist's right forearm and body, with the therapist standing to the patient's right. The therapist then placed their right index, middle, and ring fingers on the base of the occiput and held their right little finger on the spinous process of C2. Next, gentle pressure was applied ventrally and upward (45 degrees) to the lateral edge of the left thenar process and the right little finger. The gliding motion was applied rhythmically (three times per second) ten times. The therapist continuously slid the joint and actively asked the patient to move their head towards the side where the dysfunction and pain were located. He held the SNAG technique for 10 seconds. This technique was repeated 10 times over approximately 8 minutes.
Myofascial release therapy
Other interventionThe procedure was performed on the upper part of the trapezius muscle and the levator scapulae muscle. The patient was in a seated position, hips higher than knees, feet slightly in front of the knees and in full contact with the ground. The therapist stood behind the patient. Myofascial release of the trapezius was performed unilaterally with a soft fist, while the patient lowered their head forward and slowly rotated, creating a tension line from the middle of the trapezius towards the acromion process. During this time, the patient was asked to turn their head to the opposite side. Then, the therapist applied resistance to the opposite side of the rotation for 10 seconds. MGT was repeated 5 times on the trapezius. The therapist applied the same unilateral contraction, but the tension line was slightly laterally towards the lower edge of the scapula. The therapist then asked the patient to tilt their head forward to increase resistance on the levator scapula for 10 seconds.
Exercise therapy
Other interventionAll patients were given a home exercise program consisting of neck joint range of motion exercises, trapezius stretches, and isometric strengthening exercises for the neck muscles. The home exercise program was initiated with 3 sets of 10 repetitions per day. The exercises were demonstrated practically by the physician, and all patients were given a printed sheet showing how to perform the exercises. Patients were contacted by phone once a week to inquire about their adherence to the exercise program and were encouraged to follow it. Patients with exercise adherence below 75-80% were excluded from the study.
Frequency of cervicogenic headache
To determine the frequency of cervicogenic headaches, patients were given a headache diary.
assessment of pain intensity VAS pain (0-10)
0 no pain, 10 unbearable/maximum pain
Headache impact scale (HIT)
This scale was used to assess how much headaches affected patients' school, home, and social lives. The score range is 36-78. Higher scores indicate that headaches have a greater impact on your life.
Headache disability inventory/indexi ( HDI )
This 25-item questionnaire helps assess the impact of headaches and their treatment on daily life. Patients answer the questions on the questionnaire with yes (4 points), sometimes (2 points), and no (0 points). The total score is calculated out of 0-100. The results are classified as follows: 0-14 points no/very mild disability, 15-36 points mild, 37-60 points moderate, and 61-100 points severe disability.
Assessment of quality of life short form-12
It consists of 12 questions, and the answers to these questions are used to calculate a series of subscales and an overall general health score. Subscale scores are graded on a scale of 0 to 100. As the score increases from 0 (zero) to 100 (one hundred), it means the health condition is improving.
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