Manipulation and Dry Needling for Cervicogenic Headache
Recruiting in Palo Alto (17 mi)
Overseen byJames Dunning, PhD, DPT
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Alabama Physical Therapy & Acupuncture
Disqualifiers: Concussion, Fibromyalgia, Hypertension, Diabetes, others
No Placebo Group
Trial Summary
What is the purpose of this trial?The purpose of this research is to compare two different approaches for treating patients with cervicogenic headaches associated with type II whiplash associated disorder: non-thrust mobilization and exercise versus thrust manipulation and dry needling. Physical therapists commonly use all of these techniques to treat cervicogenic headaches. This study is attempting to find out if one treatment strategy is more effective than the other.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of this treatment for cervicogenic headache?
Research suggests that combining dry needling with exercises can improve neck pain and headache-related issues in people with cervicogenic headaches. Additionally, dry needling, when added to physical therapy, may enhance long-term outcomes for these headaches.
12345Is dry needling and cervical manipulation safe for treating cervicogenic headaches?
Dry needling and cervical manipulation are generally considered safe, but there are rare cases of serious adverse events with cervical manipulation. Most studies report only minor, temporary side effects.
14678How does the treatment of manipulation and dry needling for cervicogenic headache differ from other treatments?
This treatment is unique because it combines dry needling (using thin needles to target muscle knots) and thrust manipulation (a quick, controlled movement to adjust the spine), which may address both muscle tension and spinal alignment issues, unlike other treatments that might focus on just one aspect.
910111213Eligibility Criteria
This trial is for individuals with cervicogenic headaches, which are often caused by neck issues and can follow a whiplash injury (WAD II). Participants should have these specific types of headaches to qualify.Inclusion Criteria
I have had headaches at least once a week since my whiplash injury.
Neck Disability Index score of greater than 10/50 on the NDI
My headaches are more intense than a mild ache.
+3 more
Exclusion Criteria
I have been diagnosed with fibromyalgia.
I have been diagnosed with or am showing signs of a concussion.
Positive screen for cervical radiography (Canadian C-Spine Rules)
+11 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive either dry needling and thrust manipulation or exercise and non-thrust mobilization for cervicogenic headaches and type II whiplash associated disorder
4 weeks
1-2 visits per week (up to 8 sessions total)
Follow-up
Participants are monitored for changes in headache intensity, frequency, and other outcomes
3 months
Participant Groups
The study compares two treatment methods for cervicogenic headaches: one combines non-thrust mobilization and exercise; the other uses thrust manipulation and dry needling. The goal is to see which strategy works better.
2Treatment groups
Experimental Treatment
Active Control
Group I: Dry Needling,Thrust ManipulationExperimental Treatment1 Intervention
Dry needling to the craniofacial, upper cervical, and cervicothoracic regions. High-velocity thrust manipulation to the upper cervical spine, mid/lower cervical spine, and cervicothoracic spinal regions.
Group II: Exercise,Non-thrust MobilizationActive Control1 Intervention
Nonthrust joint mobilization to the upper cervical spine, mid/lower cervical spine, and cervicothoracic spinal regions. Cranio-cervical flexion exercises, peri-scapular progressive resistance exercises, and electrothermal modalities
Dry Needling is already approved in United Kingdom, United States for the following indications:
🇬🇧 Approved in United Kingdom as Dry Needling for:
- Knee osteoarthritis pain management
- Muscle strength improvement
- Leg function enhancement
🇺🇸 Approved in United States as Dry Needling for:
- Chronic knee pain relief
- Musculoskeletal pain management
- Myofascial pain syndrome treatment
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Alabama Physical Therapy & AcupunctureMontgomery, AL
Loading ...
Who Is Running the Clinical Trial?
Alabama Physical Therapy & AcupunctureLead Sponsor
Universidad Rey Juan CarlosCollaborator
References
The utilization of dry needling and an upper extremity exercise program for individuals with cervicogenic headaches: A pilot study. [2022]To investigate whether a combination of dry-needling treatments and upper extremity neuromuscular reeducation exercises can significantly improve neck pain and/or headache-related disability, joint position error, cervical range of motion, and pain pressure threshold in individuals suffering from cervicogenic headache (CGH).
Evidence for the use of dry needling and physiotherapy in the management of cervicogenic or tension-type headache: a systematic review. [2022]There is good evidence in the literature supporting physiotherapy in the management of some forms of headache. Dry needling of myofascial trigger points is becoming an increasingly common approach despite a paucity of research evidence supporting its use. The purpose of this review was to determine the evidence supporting the use of dry needling in addition to conventional physiotherapy in the management of tension-type and cervicogenic headache.
Immediate Effects of Dry Needing or Manual Pressure Release of Upper Trapezius Trigger Points on Muscle Activity During the Craniocervical Flexion Test in People with Chronic Neck Pain: A Randomized Clinical Trial. [2022]To compare the effects of dry needling or manual pressure release on an active trigger point in the upper trapezius on craniocervical flexion test performance, pressure pain thresholds, and cervical range of motion in chronic neck pain.
Comparison of acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache. [2018]The purpose of this study was to compare the acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache.
The Effect of Adding Dry Needling to Physical Therapy in the Treatment of Cervicogenic Headache: A Randomized Controlled Trial. [2022]To compare the long-term effect of adding real or sham dry needling with conventional physiotherapy in cervicogenic headache.
Adverse events associated with the use of cervical manipulation and mobilization for the treatment of neck pain in adults: a systematic review. [2022]Adverse events (AE) are a concern for practitioners utilizing cervical manipulation or mobilization. While efficacious, these techniques are associated with rare but serious adverse events. Five bibliographic databases (PubMed, CINAHL, PEDro, AMED, EMBASE) and the gray literature were searched from 1998 to 2009 for any AE associated with cervical manipulation or mobilization for neck pain. Randomized controlled trials (RCTs), prospective or cross-sectional observational studies were included. Two independent reviewers conducted study selection, method quality assessment and data abstraction. Pooled relative risks (RR) were calculated. Study quality was assessed using the Cochrane system, a modified Critical Appraisal Skills Program form and the McHarm scale to assess the reporting of harms. Seventeen of 76 identified citations resulted in no major AE. Two pooled estimates for minor AE found transient neurological symptoms [RR 1.96 (95% CI: 1.09-3.54) p .05]. Forty-four studies (58%) were excluded for not reporting AE. No definitive conclusions can be made due to a small number of studies, weak association, moderate study quality, and notable ascertainment bias. Improved reporting of AE in manual therapy trials as recommended by the CONSORT statement extension on harms reporting is warranted.
Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis. [2023]Label="Objective">To evaluate the effects of combining dry needling with other physical therapy interventions versus the application of the other interventions or dry needling alone applied over trigger points (TrPs) associated to neck pain. Databases and Data Treatment. Electronic databases were searched for randomized controlled trials where at least one group received dry needling combined with other interventions for TrPs associated with neck pain. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool, methodological quality was assessed with PEDro score, and the quality of evidence was assessed by using the GRADE approach. Between-groups mean differences (MD) and standardized mean difference (SMD) were calculated.
Effectiveness of Dry Needling for Myofascial Trigger Points Associated with Neck Pain Symptoms: An Updated Systematic Review and Meta-Analysis. [2020]Our aim was to evaluate the effect of dry needling alone as compared to sham needling, no intervention, or other physical interventions applied over trigger points (TrPs) related with neck pain symptoms. Randomized controlled trials including one group receiving dry needling for TrPs associated with neck pain were identified in electronic databases. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The Cochrane risk of bias tool and the Physiotherapy Evidence Database (PEDro) score were used to assessed risk of bias (RoB) and methodological quality of the trials. The quality of evidence was assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Between-groups mean differences (MD) and standardized mean differences (SMD) were calculated (3) Twenty-eight trials were finally included. Dry needling reduced pain immediately after (MD -1.53, 95% CI -2.29 to -0.76) and at short-term (MD -2.31, 95% CI -3.64 to -0.99) when compared with sham/placebo/waiting list/other form of dry needling and, also, at short-term (MD -0.51, 95% CI -0.95 to -0.06) compared with manual therapy. No differences in comparison with other physical therapy interventions were observed. An effect on pain-related disability at the short-term was found when comparing dry needing with sham/placebo/waiting list/other form of dry needling (SMD -0.87, 95% CI -1.60 to -0.14) but not with manual therapy or other interventions. Dry needling was effective for improving pressure pain thresholds immediately after the intervention (MD 55.48 kPa, 95% CI 27.03 to 83.93). No effect on cervical range of motion of dry needling against either comparative group was found. No between-treatment effect was observed in any outcome at mid-term. Low to moderate evidence suggests that dry needling can be effective for improving pain intensity and pain-related disability in individuals with neck pain symptoms associated with TrPs at the short-term. No significant effects on pressure pain sensitivity or cervical range of motion were observed. Registration number: OSF Registry-https://doi.org/10.17605/OSF.IO/P2UWD.
The methodology and operation of a pilot randomized control trial of the effectiveness of the Bug Busting method against a single application insecticide product for head louse treatment. [2016]A Department of Health leaflet suggests two treatment methods for head lice: mechanical removal by wet combing; and insecticide lotion/rinses. However, there are no reports in the literature comparing the effectiveness of these two treatment methods and well controlled clinical trials of insecticide treatments are sparse. A pilot randomized control trial of the effectiveness of a specific method of wet combing, 'Bug Busting', against a single application of a proprietary insecticide product is reported. The difficulties of designing a trial are discussed and modifications that would allow a definitive trial to take place are suggested. The pilot study included enzyme analysis of lice for insecticide resistance status assessment.
Systematic review of clinical efficacy of topical treatments for head lice. [2019]To collect and evaluate all trials on clinical efficacy of topical treatments for head lice.
Pediculosis capitis: an update. [2012]Head louse infestation, or pediculosis capitis, caused by Pediculus humanus var. capitis, is a common health concern in pediatric age group. An itching of the scalp is the chief symptom, whereas presence of viable nits confirms the diagnosis of head louse infestation. Secondary bacterial infection with impetignization with cervical and occipital lymphadenopathy can complicate the clinical scenario with physician misdiagnosing pediculosis to a primary bacterial infection. Screening and treatment of all close contacts is necessary for an adequate management of pediculosis. Medical management of head louse infestation requires proper application of topical pediculicidal agents', chiefly permethrin lotion and wet combing with a fine toothcomb. Severe cases with high parasitic load justify the use of either oral cotrimoxazole or Ivermectin. Other described technique involves a single application of hot air for 30 minutes. Radical but culturally unacceptable method would be shaving of scalp in resistant cases. Environmental fogging with insecticides is neither necessary nor recommended.
Efficacy of the LouseBuster, a new medical device for treating head lice (Anoplura:Pediculidae). [2019]Human head lice (Pediculus humanus capitis De Geer) occur worldwide and infest millions of children and adults every year. Head lice infestations, which are known as pediculosis capitis, are psychologically stressful, physically irritating, and are one of the leading causes of K-6 school absence. The prevalence of head lice in many countries is increasing rapidly because of resistance to chemicals used in many head lice treatments. We tested the efficacy of an alternative method for controlling head lice, the LouseBuster, a custom-built medical device designed to kill head lice and their eggs using controlled, heated air. A total of 56 infested subjects was treated with the LouseBuster, and the efficacy of the treatment was evaluated by comparing the viability of lice and eggs on randomly assigned pre- and posttreatment sides of each subject's scalp. We evaluate treatment efficacy in the hands of novice versus experienced operators. We also evaluate treatment efficacy on different hair types and at different ambient humidities. Overall mortality of lice and eggs was 94.8% after treatment by experienced operators. Novice operators also achieved good results after a short training session; their results did not differ significantly from those of experienced operators. No adverse events were associated with the LouseBuster treatment. The LouseBuster is efficacious for killing head lice and their eggs. The use of heated air is appealing because it is a fast, safe, nonchemical treatment. Head lice are also unlikely to evolve resistance to desiccation, which is the apparent mode of action.
The effect of larval selection on adult resistance to DDT in two strains of the mosquito Aedes aegypti (L). [2019]Evidence is presented which confirms the influence of linkage group II on adult DDT-resistance in one strain of Aedes aegypti (Bangkok-MR) but not in another strain (Bangkok-HR).