Additional Effects of Sternocleidomastoid Release With SNAGS in the Management of Cervicogenic Headache

Foundation University Islamabad

Status: Active, not recruiting

Conditions: Cervicogenic Headache

Treatments: Procedure: Sternocleidomastoid Release; Procedure: Headache SNAGs; Procedure: Electrotherapy and physical agents

Study type: Interventional

Funder types: Other

Identifiers

NCT06534606

FUI/CTR/2024/17

Details and patient eligibility

About

Cervicogenic headache is a common type of headache in adults which causes disability and difficulty in everyday activities. According to the latest International Headache Society model, cervicogenic headache (CGH) is a secondary headache having C1-C2 dysfunction. SNAGs are highly effective in the treatment approach for these patients. Sternocleidomastoid muscle receive overactive tension from forward neck posture, increasing muscular fatigue and tone of muscles. This tension in SCM causes referred pain in the head and neck region. SNAGs are very effective but musculoskeletal impairments especially the tightness of sternocleidomastoid muscle still persist and can exacerbate symptoms. Manual therapy targeted to the SCM muscle may be effective for reducing headache and neck pain intensity and increasing performance of deep cervical flexors. Findings of this study will aid the therapists in choosing which technique to use while treating the patients. This will save therapist's time and effort as they will not be using the less effective treatment protocol. Furthermore, patient's time and investment will be used in the right direction.

Enrollment: 38 estimated patients

Sex: All

Ages: 18 to 45 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age group: 18-45 years old
• Both males and females
• Unilateral headache with no shift of side
• C1-C2 Dysfunction
• Positive flexion rotation test (Rotation restriction is greater than 10 degrees)
• Headache at least once a month in the last 3 months
• Headache with at least 4 score in NPRS (Sign and Symptoms of Neck Involvement)
• Headache with restriction of ROM in the neck
• Headache precipitated by:

Sustained neck movements, and awkward head positioning. External Pressure over upper cervical or occipital region

Headache Characteristics:

• Moderate-severe, non-throbbing pain, usually starting in the neck.
• Episodes of varying duration, or: fluctuating, continuous pain

Exclusion criteria

• Headache of non-cervical origin
• Diagnosed Cases of:Cervical spondylosis,Cervical radiculopathy/ nerve root involvement/ disc herniation,Cervical instability/ fracture,Vertebrobasilar insufficiency ,Cervical spine surgery,Cervical spondylolisthesis,Spinal infection or tumors,Osteoporosis,History of trauma,Rheumatoid Arthritis,Inflammatory Arthritis

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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38 participants in 2 patient groups

Conventional physical therapy Group

Active Comparator group

Description:

Both Group A and Group B will receive this conventional physical therapy protocol for cervicogenic headache. * Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks. * TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks. In addition to this, they will receive Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold. • Frequency: 3 times a week for 2 weeks. 6 sessions in total.

Treatment:

Procedure: Electrotherapy and physical agents

Procedure: Headache SNAGs

Conventional physical therapy with sternocleidomastoid release

Experimental group

Description:

Both Group A and Group B will receive this conventional physical therapy protocol for cervicogenic headache. * Moist heat therapy: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks. * TENS application: Frequency: 15 minutes, 3 times per week (alternatively) for 2 weeks. Headache SNAGs: In addition to the conventional physical therapy protocol, they will receive Headache SNAGs (Sustained Natural Apophyseal Glides) 5 sets of 10 repetitions. Each repetition will be given with a 10 second hold. * Frequency: 3 times a week for 2 weeks. 6 sessions in total. Sternocleidomastoid Release: Group B will also receive Sternocleidomastoid release in addition with headache SNAGs. Release to the sternocleidomastoid muscle will be given once per session for 5-8 minutes. * Frequency: 3 times a week for 2 weeks. 6 sessions in total.

Treatment:

Procedure: Electrotherapy and physical agents

Procedure: Headache SNAGs

Procedure: Sternocleidomastoid Release