Sub-occipital myofascial release technique in subjects with cervicogenic headache Download PDF

Aim: Cervicogenic headache is defined as unilateral headache which is referred from upper cervical spine structures. Myofascial release as a new intervention is currently being applied for patients with cervicogenic headache but its efficacy has not been evaluated formally. Objectives: To determine whether sub-occipital myofascial release technique in upper cervical region is more effective than the use of conventional exercises in improvement of the headache intensity, frequency, duration and pressure pain threshold in subjects with cervicogenic headache. Material and Method: We carried out a prospective, randomized controlled, and blinded trial in 34 subjects with cervicogenic headache within the age range of 15-75 years who were assigned randomly to an Exercise group (N = 17, mean age = 38 ± 11.31) and Myofascial Release group (N = 17, mean age = 38.88 ± 9.38). Ten treatment sessions, six times a week were applied for each group. Main outcome measures were defined as: frequency and duration of headache, intensity of headache and pressure pain threshold of spinous and transverse process of upper cervical joints. Results: ¬Statistical analysis (paired t-test) showed a significant improvement in headache intensity, frequency, duration and pressure pain threshold after treatment in the myofascial release and exercise groups compared to before treatment (P < 0.05) except PPT of Left C2 transverse process in Exercise group and headache duration in MFR group (P > 0.05). In the ANCOVA and pre-test scores as a control, no significant difference was found between the two groups after ten treatment sessions for all variables (P > 0.05) except PPT of Right C2 transverse process (P = 0.010) Discussion: The application of sub-occipital myofascial release and common exercises produce a rapid and early return improvement in pain intensity, frequency and Pressure Pain Threshold in subjects with cervicogenic headache.