Cervical-Cranial Dry Needling vs. Orthopedic Manual Therapy for Cervicogenic Headache
| Status: | Recruiting |
|---|---|
| Conditions: | Migraine Headaches |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/3/2018 |
| Start Date: | July 5, 2018 |
| End Date: | June 10, 2022 |
| Contact: | David Griswold, PhD |
| Email: | dwgriswold@ysu.edu |
| Phone: | 330-941-2419 |
Comparing the Use of Cervical-Cranial Dry Needling With Orthopedic Manual Therapy to the Cervical Spine for Cervicogenic Headache: A Multi-center RCT With 1-Year Follow Up
Dry needling is a therapeutic modality used to treat a number of neuromusculoskeletal
conditions. Practice trends suggest it is becoming widely used by Physical Therapists to help
patients manage symptoms associated with CGH, however, there is limited scientific evidence
demonstrating meaningful impact for dry needling for CGH. Manual therapy (thrust and
non-thrust mobilizations) to the cervical spine are well researched and have an established
treatment effect for managing symptoms related to CGH. The purpose of this study is to
compare outcomes (1 week, 1 month, 3 months, 12 months) for patients with CGH treated with
cervical-cranial dry needling or pragmatically applied orthopedic manual therapy to the
cervical spine. In addition to either the cervical-cranial dry needling or manual therapy to
the cervical spine, patients will also receive patient education, thoracic manipulation, and
exercise.
conditions. Practice trends suggest it is becoming widely used by Physical Therapists to help
patients manage symptoms associated with CGH, however, there is limited scientific evidence
demonstrating meaningful impact for dry needling for CGH. Manual therapy (thrust and
non-thrust mobilizations) to the cervical spine are well researched and have an established
treatment effect for managing symptoms related to CGH. The purpose of this study is to
compare outcomes (1 week, 1 month, 3 months, 12 months) for patients with CGH treated with
cervical-cranial dry needling or pragmatically applied orthopedic manual therapy to the
cervical spine. In addition to either the cervical-cranial dry needling or manual therapy to
the cervical spine, patients will also receive patient education, thoracic manipulation, and
exercise.
The use of dry needling is becoming widely used by Physical Therapists in the United States
for a number of neuromusculoskeletal conditions including cervicogenic headache (CGH). Dry
needling is performed by taking a mono-filament needle and inserting it into symptomatic soft
tissue. In this trial, the dry needling will be performed segmentally in the neck and along
the patient's headache distribution pattern. Orthopedic manual therapy (OMT) may include both
thrust and non-thrust techniques applied to a targeted spinal level and has a
well-established treatment effect for patients with CGH. In this trial, the OMT will be
applied pragmatically to the cervical spine at the most symptomatic level of the headache.
Other interventions used in this trial will include patient education, thoracic manipulation
and exercise.
Patients will be randomized to receive either dry needling or OMT 2x/week for 2 weeks and
then 1-2x/week for 2 weeks totaling 6-8 visits over the course of 1 month. The 1 week and 1
month outcomes collected will be reported on separately from the 3 and 12 months.
for a number of neuromusculoskeletal conditions including cervicogenic headache (CGH). Dry
needling is performed by taking a mono-filament needle and inserting it into symptomatic soft
tissue. In this trial, the dry needling will be performed segmentally in the neck and along
the patient's headache distribution pattern. Orthopedic manual therapy (OMT) may include both
thrust and non-thrust techniques applied to a targeted spinal level and has a
well-established treatment effect for patients with CGH. In this trial, the OMT will be
applied pragmatically to the cervical spine at the most symptomatic level of the headache.
Other interventions used in this trial will include patient education, thoracic manipulation
and exercise.
Patients will be randomized to receive either dry needling or OMT 2x/week for 2 weeks and
then 1-2x/week for 2 weeks totaling 6-8 visits over the course of 1 month. The 1 week and 1
month outcomes collected will be reported on separately from the 3 and 12 months.
Inclusion Criteria:
- 18 years or older
- Meets the IHS criteria for CGH
- Headache frequency of at least 1 per week over a period greater than 3 months.
- Demonstrates segmental dysfunction with passive mobility testing.
Exclusion Criteria:
Patients whose headache experience is primarily of migraine origin. Tension-type headache,
headache pain <2, contraindications to the interventions (malignancy, myelopathy, fracture,
metabolic disease, rheumatoid arthritis, long-term corticosteroid use), headache
presentation suggesting cervical arterial insufficiency, severe metal allergy, needle
phobia, history of neck or thoracic spine surgery, Non-English speaking patients, therapist
is unable to elicit the headache with passive accessory intervertebral movements (PAIVM),
or pending litigation for neck pain and/or headache.
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