Effects of manual therapy on cervicogenic headaches: a therapeutic approach

Abstract

The cervical spine is considered a possible source of headaches, however there are still some controversies regarding the pathophysiology, clinical presentation, and treatment. Objective: To propose a physical therapy treatment protocol with multimodal approach for cervicogenic headache and evaluate the effects of manual therapy on such patients. Method: This was an uncontrolled experimental study in which 9 patients from the UNIFESO Physical Therapy Clinic (Teresópolis, RJ) diagnosed with cervicogenic headache underwent 10 physiotherapy interventions with manual therapy techniques. The experimental protocol included joint techniques, fascial release, and muscle recruitment. The Neck Disability Index (NDI) and a visual analogic scale (VAS) were used as measurement tools and the pain pattern was recorded. Results: Of the nine selected patients, all were female and had an average age of 43.3 years (± 15.5). Significant differences were observed between the average intensity of pain (VAS) before treatment (8.0 ± 1.3) and after (2.2 ± 0.9, p < 0.01). The NDI also showed improvement after intervention 63.9% (p < 0.01). Regarding crises frequency, a decrease of 70% was observed after the intervention (p < 0.01) and a reduction was also shown in the duration of such crises before (4 hours ± 1.5) and after treatment (1 hour ± 0.5; p < 0.01). Conclusion: A multimodal approach by manual therapy techniques was beneficial in the reduction of the patients' symptoms and it provided a decrease in cervical disability.

Efeitos da terapia manual no tratamento de portadores de cefaleia: uma revisão integrativa

“…Quanto à avaliação da atividade e participação do indivíduo, este aspecto é complexo, uma vez que engloba o desempenho, capacidade e a qualidade de vida do www.scientificsociety.net 511 individuo 13 . Diante disso, é importante o olhar sensibilizado para o complexo processo saúde-doença.…”

Análise da mobilização articular da cervical em indivíduos com cefaleia do tipo tensão

“…Os tratamentos para a CTT envolvem terapias medicamentosas e não medicamentosas. Dentre as terapias não medicamentosas, destaca-se a fisioterapia, que pode se configurar como uma importante abordagem para minimizar este problema, atuando no controle sintomatológico 5,6 . Uma das técnicas para o controle álgico é a terapia manual, e dentro deste contexto, Mulligan, em 1987, propôs a técnica "sustained natural apophyseal glide (SNAGS)", em português "deslizamento natural apofisário sustentado", para as situações onde há restrição de movimento da coluna cervical por dor.…”