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The intervention will consist of the nursing staff applying 2 grams of diclofenac 1% gel topically to the posterior cervical region four times daily. The control group will receive petroleum jelly topically to the posterior cervical region four times daily. Patients will receive a pre-intervention and post-intervention survey incorporating the Numeric Assessment Scale and Headache Impact Test-6.
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Inclusion criteria
Exclusion criteria
Primary headache secondary to intracranial pathology (i.e. tumors)
a. While TBI and Stroke patients can suffer headaches as a sequalae of their intracranial pathologies, it is not always the case that their headache is primarily secondary to their pathology but due to other etiologies such as cervicogenic headache or myofascial pain syndrome. History and physical examination by the medical team will help aid in determining the headache's etiology.
Patients on dual antiplatelet therapy
a. Aspirin 81mg daily or Clopidogrel (or antiplatelet monotherapy) is acceptable
History of cervical spine procedures
a. Spinal cord injury patients with cervical neck injuries that have required operative repair will be excluded from the study.
Nerve blocks within past 4 weeks or steroid injections within past 6 months.
Patients with fibromyalgia
Pregnant women
Chronic pain on continuous opiate regimen (use of opioids on most days >90 days)
Discharged in less than 14 days from acute inpatient rehabilitation
Any contraindication use per diclofenac gel package insert:
Development of adverse reaction resulting in discontinuation of diclofenac gel
Primary purpose
Allocation
Interventional model
Masking
0 participants in 2 patient groups, including a placebo group
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Central trial contact
Duc Tran, MD, PhD; Cristian Villegas, MD
Data sourced from clinicaltrials.gov
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