Manipulation & Dry Needling vs. Mobilization & Massage for Tension Headaches
Palo Alto (17 mi)Overseen byJames Dunning, DPT PhD
Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: N/A
Recruiting
Sponsor: Alabama Physical Therapy & Acupuncture
No Placebo Group
Trial Summary
What is the purpose of this trial?This trial compares two treatment methods for people with tension headaches. One method uses chiropractic adjustments, needling, and exercise, while the other uses gentle joint movements, massage, exercise, and electrical stimulation. The goal is to see which method works better at reducing headache pain.
What safety data exists for treatments involving manipulation, dry needling, and TENS for tension headaches?The studies reviewed provide safety data for treatments involving manipulation, dry needling, and TENS. These treatments have been evaluated for conditions like cervicogenic headaches, myofascial pain, fibromyalgia, and acute pain. TENS is a non-pharmacological intervention used for pain relief, and studies have shown its effectiveness in combination with other therapies like joint manipulation. Both dry needling and TENS have shown significant improvements in pain and range of motion in patients with neck pain due to myofascial trigger points, indicating their safety and efficacy in similar conditions.348910
Is the treatment of Non-thrust Mobilization, Soft-Tissue Mobilization, Exercise, TENS, Thrust Manipulation, Electric Dry Needling, and Exercise promising for tension headaches?Yes, this treatment is promising for tension headaches. Studies show that techniques like dry needling and TENS can help reduce pain and improve neck movement. These methods, along with exercises and mobilization, offer a non-drug approach to managing headaches.235610
What data supports the idea that Manipulation & Dry Needling vs. Mobilization & Massage for Tension Headaches is an effective treatment?The available research shows that both Manipulation & Dry Needling and Mobilization & Massage can be effective treatments for tension headaches. One study found that soft tissue techniques and neural mobilization techniques, which are similar to Mobilization & Massage, were effective in managing tension-type headaches. Additionally, another study comparing dry needling and transcutaneous electrical nerve stimulation (TENS) for neck pain, which is related to tension headaches, showed significant improvement in pain and movement. This suggests that dry needling, a part of Manipulation & Dry Needling, can also be beneficial. While the studies focus on related conditions, they indicate that these treatments can help reduce pain and improve function.137910
Do I need to stop my current medications to join the trial?The trial protocol does not specify if you need to stop taking your current medications. However, if you have a Medication Overuse Headache, you would be excluded from the trial.
Eligibility Criteria
This trial is for adults aged 18-65 with frequent episodic or chronic tension-type headaches and tenderness around the head. Participants must not have had recent neck/head treatments, surgery, trauma, or conditions like fibromyalgia. Pregnant individuals or those involved in related litigation are excluded.Inclusion Criteria
I am between 18 and 65 years old.
I have frequent or chronic tension headaches.
I have frequent headaches with scalp tenderness.
I have chronic headaches with tenderness around my head.
I experience tension-type headaches.
Exclusion Criteria
I have headaches from using too much headache medicine.
I have had a head or neck injury, including whiplash.
My cancer has spread to my brain or spinal cord.
I have at least two signs of nerve damage due to pressure on my nerves.
I have symptoms in both of my arms.
I have had surgery on my neck or upper back.
I have a condition that may not allow for spinal manipulation treatment.
I have been diagnosed with fibromyalgia.
I have a history of cervical stenosis.
Treatment Details
The study compares two headache treatment methods: one combines thrust manipulation, electric dry needling and exercise; the other uses non-thrust mobilization, soft-tissue work, exercise and TENS (a type of electrical nerve stimulation).
2Treatment groups
Experimental Treatment
Active Control
Group I: thrust manipulation, electric dry needling and exerciseExperimental Treatment1 Intervention
thrust manipulation, electric dry needling and exercise
Group II: non-thrust Mobilization, Soft-Tissue Mobilization, Exercise and TENSActive Control1 Intervention
non-thrust mobilization, soft-tissue mobilization, exercise and TENS
Non-thrust Mobilization, Soft-Tissue Mobilization, Exercise and TENS is already approved in United States, European Union, Canada for the following indications:
🇺🇸 Approved in United States as Physical Therapy Modalities for:
- Tension-type headaches
- Musculoskeletal pain
- Rehabilitation
🇪🇺 Approved in European Union as Physical Therapy Modalities for:
- Tension-type headaches
- Musculoskeletal disorders
- Pain management
🇨🇦 Approved in Canada as Physical Therapy Modalities for:
- Tension-type headaches
- Musculoskeletal injuries
- Chronic pain
Find a clinic near you
Research locations nearbySelect from list below to view details:
Maller and Swoverland Orthopedic PTFort Wayne, IN
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Who is running the clinical trial?
Alabama Physical Therapy & AcupunctureLead Sponsor
Universidad Rey Juan CarlosCollaborator
References
[Exercise therapy in E.N.T]. [2009]A non exhaustive survey of physiotherapy methods and techniques in "soft E.N.T. treatment" is briefly described. Without using "strength or brutality" which might retard the patient's recovery, the physiotherapist should focus his efforts to regain optimal functioning of the affected structure. So, physiotherapy techniques such as relaxation, bio-feedback, massage, exercise and electrotherapy, are used for a successful treatment of headache, migraine, vertigo, peripheral facial palsy, neck, cervico-facial (awkward positioning) and temporo-mandibular joint problems. Manual lymphatic drainage in post-surgical regeneration of skin and underlying structures, an example of very soft technique suits perfectly in the context of "soft E.N.T."
The 'dry-needle technique': intramuscular stimulation in tension-type headache. [2017]The 'dry-needle technique', an intramuscular stimulation technique carried out by using a fine solid, 1-inch long, 30-gauge needle, was investigated in the treatment of tension-type headache (TTH) in a randomized, placebo-controlled trial. Fifteen patients with TTH received intramuscular needle insertions into six designated trigger points, while 15 controls received subcutaneous insertions. Headache indices, muscle tenderness and neck ROMs were evaluated before and after treatment. Mean headache indices improved significantly after treatment, both in the treatment group and in the placebo group, but the difference between the two groups was insignificant. In the treatment group the tenderness score and the neck ROM limitation score were significantly improved after treatment, while there was no significant improvement in the placebo group. We conclude that more and larger controlled, comparative trials are needed to show whether the dry-needle technique is an effective non-pharmacological alternative for the treatment of TTH.
[Comparative study on effects of manipulation treatment and transcutaneous electrical nerve stimulation on patients with cervicogenic headache]. [2019]To compare the effects of manipulation treatment and transcutaneous electrical nerve stimulation (TENS) on patients with cervicogenic headache.
Transcutaneous electrical nerve stimulation for acute pain. [2022]Transcutaneous Electrical Nerve Stimulation (TENS) is a non-pharmacological agent, based on delivering low voltage electrical currents to the skin. TENS is used for the treatment of a variety of pain conditions.
Effects of burst-type transcutaneous electrical nerve stimulation on cervical range of motion and latent myofascial trigger point pain sensitivity. [2022]To assess the effects of a burst application of transcutaneous electrical nerve stimulation (TENS) on cervical range of motion and pressure point sensitivity of latent myofascial trigger points (MTrPs).
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.
Effectiveness of a Treatment Involving Soft Tissue Techniques and/or Neural Mobilization Techniques in the Management of Tension-Type Headache: A Randomized Controlled Trial. [2022]To evaluate the effects of a protocol involving soft tissue techniques and/or neural mobilization techniques in the management of patients with frequent episodic tension-type headache (FETTH) and those with chronic tension-type headache (CTTH).
Hypoalgesic Effects of Transcutaneous Electrical Nerve Stimulation Combined With Joint Manipulation: A Randomized Clinical Trial. [2021]The objective of this study was to compare the hypoalgesic effects of isolated or combined use of transcutaneous electrical nerve stimulation (TENS) and cervical joint manipulation (JM) in asymptomatic participants.
The Fibromyalgia Transcutaneous Electrical Nerve Stimulation in Physical Therapy Study Protocol: A Multisite Embedded Pragmatic Trial. [2023]Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological intervention that provides an electrical current through the skin to produce analgesia. The primary purpose of this study is to examine if the addition of TENS to routine physical therapy improves movement-evoked pain in individuals with fibromyalgia in a physical therapy clinical setting.
Efficacy of Dry Needling Versus Transcutaneous Electrical Nerve Stimulation in Patients With Neck Pain Due to Myofascial Trigger Points: A Randomized Controlled Trial. [2023]Introduction Myofascial pain is defined as pain arising primarily in muscles and associated with multiple trigger points. Among the non-pharmacological methods, trigger point injection and electrotherapy are effective methods to treat myofascial pain syndrome. This study compares the effectiveness of dry needling (DN) and transcutaneous electrical nerve stimulation (TENS) in reducing cervical pain intensity and improving cervical range of motion in patients with neck pain due to myofascial trigger points. Methods Fifty patients were enrolled and randomized into two groups. Patients in group A received dry needling, and those in group B received TENS. Patients were evaluated using the Visual Analog Scale (VAS), Neck Disability Index (NDI), and Cervical Range of Motion (CROM) before the treatment and on days 14 and 28 after the treatment. The unpaired t-test was used to evaluate quantitative data, except for VAS, where the Mann-Whitney U test was used. All quantitative variables had a normal distribution with a standard deviation except for pain intensity (VAS), which deviated from the normal distribution. The significance level was set at a P-value=0.05. Results Both DN and TENS groups showed significant improvement in VAS, NDI, and CROM between days 0 and 28 (p=