Effectiveness of C1-C2 Snag Mobilization and Deep Cervical Flexor Strengthening in a Patient With Cervicogenic Headache: A Case Report.

Abstract

Background- Cervicogenic headache is a unilateral headache felt in the occipital,temporal or orbital region and is a common finding in patients suffering from neck pain, ranging from mild to severe in intensity.Several interventions are effective in treating neck pain with headaches that focus on the muscles and joints of the posterior neck.The purpose of this case report is to describe the efficacy of C1-C2 SNAG mobilization and deep cervical flexor muscle (DCFM) strengthening in reducing cervicogenic headache. Case Description: This case report describes the effect of training DCFM using a pressure biofeedback unit in addition to SNAG mobilization at C1-C2 in a 46-year-old female patient who presented with cervicogenic headache post neck pain.Upon referral to physical therapy,she was treated for 6 sessions, two sessions per week focusing on pain reduction,posture re-education,improving cervical range of motion,and muscle strength. Outcome: Physical therapy intervention targeting DCFM using pressure biofeedback unit along with manual therapy significantly reduced the patient's NPRS score from 8/10 to 3/10 within three weeks and further reduced it to 1/10 at three months and six months follow-up. Her headache duration changed from being constant to intermittent, lasting only few minutes. Neck Disability Index changed from 40 to 18. Discussion & Coclusion: Combined intervention of SNAG mobilization and DCFM training is effective in reducing pain in cervicogenic headache. This case report concluded that both treatment intervention when used in combination can be employed as the mainstay treatment in reducing frequency,intensity and duration of this condition.