Abstracts of Current Literature

Abstract

The objective of our study was to determine the effectiveness of manual therapy for balancing C1 and a home exercise program, including active neck retraction exercises performed in a series of progressions, in the treatment of cervicogenic headache. The subjects included a 42-year-old male (Subject 1) and a 25-year-old female (Subject 2), both with a primary complaint of right-side suboccipital headache. Subject 1 was functionally limited in reading, sleeping, and playing basketball. Subject 2 reported problems with working, sleeping, and running on a treadmill. Both subjects met the criteria for cervicogenic headache as adapted from the International Headache Society. On Day 1, each subject completed three self-report measures: a numeric pain scale for both worst and average headache pain as well as the Patient Specific Functional Scale. Each subject was treated on Days 1, 3, and 5. Intervention included using a muscle energy technique for balancing C1 and a home program consisting of a progression of McKenzie's retraction/extension/rotation exercises. Each subject was told he/she may continue the home program on his/her own accord every 2 hours or as a headache occurred. On days 12 and 26, each subject completed the previous three self-report measures as well as the Global Rating Scale during blinded follow-up phone visits. The subjects demonstrated an increase in functional activities, a decrease in average and worst headache pain, and an overall improvement in their perception of change in the headache. Manual therapy in addition to a home program of active neck retraction exercises in a series of progressions was successful in relieving cervicogenic headache and improving function in two subjects. Patients with cervicogenic headaches could be empowered to alleviate their own symptoms with decreased physical therapy visits and decreased cost by having a manual therapy technique performed on them followed by a home exercise program.