Tension-type Headache Clinical Trial
Official title:
Treatment of Tension-type Headache With Articulatory and Suboccipital Soft Tissue Therapy: a Double-blind, Randomized, Placebo-controlled Clinical Trial
Background. Headache is one of the most common causes of consultation in primary health care
and neurology in Europe. Cervical muscle tension can maintain a restriction of joint motion
at the suboccipital level, facilitating the referred head pain.
Objective. To evaluate the effectiveness of two manual therapy treatments for tension-type
headache.
Methods. A randomized double-blind clinical trial was conducted, for a period of 4 weeks and
a follow-up at one month post-treatment. Eighty-four patients with tension-type headache
were assigned to 4 groups (3 treatment groups and 1 control group). Treatments included
manual therapy of suboccipital soft tissue inhibition, occiput-atlas-axis global
manipulation, and a combination of both techniques. Outcome measures were: impact of
headache, disability caused by headache, ranges of motion of the craniocervical junction,
frequency and intensity of headache, and associated headache symptoms.
Results. After 8 weeks, there were significant improvements in impact of headache (p=0.01),
disability (p=0.001), and craniocervical flexion (p=0.03) for the suboccipital soft tissue
inhibition group; in headache impact and disability (p=0.000), pain intensity (p=0.02) and
craniocervical flexion (p=0.004) and extension (p=0.04) for the occiput-atlas-axis group;
and in impact (p=0.002), functional disability (p=0.000), headache frequency (p=0.002) and
intensity (p=0.001), craniocervical flexion (p=0.008) and extension (p=0.003) and associated
headache symptoms (p=0.01) for the combined therapy group, with effect sizes from medium to
large.
Conclusions. Occiput-atlas-axis and combined therapy group treatments are more effective
than suboccipital soft tissue inhibition for tension-type headache. The treatment with
suboccipital soft tissue inhibition, despite producing less significant results, also has
positive effects on different aspects of headache.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Double Blind (Subject, Caregiver, Outcomes Assessor), Primary Purpose: Treatment
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