Headaches, Tension Clinical Trial
Official title:
Mechanical Diagnosis and Therapy vs Traditional Physical Therapy in the Treatment of Mechanical Headaches
In addition to manual therapy, mobilizations, manipulations, and exercise, the McKenzie
method of Mechanical Diagnosis and Therapy (MDT) is currently being used to treat headaches.
However, there is little supportive evidence about the efficacy of this type of treatment.
The MDT method focuses on actively involving the patient in education and self-management of
pain. The focus is to have the patient learn about his/her condition and how to manage the
symptoms independently when possible.
With regards to research that has been conducted on the use of MDT with headaches, one study
compared mechanical traction, rhythmic impulse, and MDT exercises in relieving tension-type
headaches (TTH). Mechanical cervical traction was found to be more effective at reducing
headaches in both infrequent episodic and frequent episodic TTH. While MDT was used in this
study, a general treatment was prescribed to each patient in that group without consideration
to directional preference. This treatment had the patients perform the same exercises in the
same progression, including four extension exercises, one flexion exercise, two lateral
flexion exercise, and one rotation exercise. In addition, they performed the exercises for
the same length of time for the same number of repetitions. The study was unclear about
whether the exercises were administered by physical therapists or whether the practitioners
were MDT credentialed.
One case study described the treatment of a cervicogenic headache using the MDT retraction
progression along with therapeutic exercises that included deep neck flexor and extensor
strengthening and stretching of neck musculature as indicated . The patient reported that
performing retractions at home provided him relief from his headaches for progressively
longer periods of time as his treatment progressed. By the end of the treatment, the patient
no longer experienced headaches. The results from this article support the proposition that
headaches which present with mechanical origins can be successfully treated with the MDT
approach.
Headaches affect an estimated 46% of adults worldwide, and the pain can have a detrimental
effect on an individual's livelihood. In a two-week time period, 12.7% of the US workforce
was unable to productively work due to pain, with headache pain as the most common complaint.
For those with headache pain, this resulted in 3.5 +/- 0.1 hours of productivity lost in a
week. Quality of life, financial situation, employment, and social involvement are negatively
impacted by headache pain. Coworkers and family may have to handle work or personal
responsibilities that those with headaches are unable to fulfill.
In addition to manual therapy, mobilizations, manipulations, and exercise, the McKenzie
method of Mechanical Diagnosis and Therapy (MDT) is currently being used to treat headaches.
However, there is little supportive evidence about the efficacy of this type of treatment.
The MDT method focuses on actively involving the patient in education and self-management of
pain. The focus is to have the patient learn about his/her condition and how to manage the
symptoms independently when possible.
A study in Poland compared MDT interventions to a control group that received therapeutic
exercise, massage, and ultra-red radiation for patients with cervical derangement. Although
not targeted at patients with a primary complaint of headache, the percentage of patients in
the MDT group experiencing headache decreased from 80% to 3.33% whereas the percentage of
patients in the control group experiencing headaches decreased from 83.87% to 51.61%. This
indicates that MDT may be an effective treatment for headaches with a mechanical component.
With regards to research that has been conducted on the use of MDT with headaches, one study
compared mechanical traction, rhythmic impulse, and MDT exercises in relieving TTH.
Mechanical cervical traction was found to be more effective at reducing headaches in both
infrequent episodic and frequent episodic TTH. While MDT was used in this study, a general
treatment was prescribed to each patient in that group without consideration to directional
preference. This treatment had the patients perform the same exercises in the same
progression, including four extension exercises, one flexion exercise, two lateral flexion
exercise, and one rotation exercise. In addition, they performed the exercises for the same
length of time for the same number of repetitions. The study was unclear about whether the
exercises were administered by physical therapists or whether the practitioners were MDT
credentialed.
One case study described the treatment of a cervicogenic headache using the MDT retraction
progression along with therapeutic exercises that included deep neck flexor and extensor
strengthening and stretching of neck musculature as indicated . The patient reported that
performing retractions at home provided him relief from his headaches for progressively
longer periods of time as his treatment progressed. By the end of the treatment, the patient
no longer experienced headaches. The results from this article support the proposition that
headaches which present with mechanical origins can be successfully treated with the MDT
approach.
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