Date of Award

5-1-2023

Degree Type

DPT Project

Degree Name

Doctor of Physical Therapy (DPT)

Advisor

Balachandar Kathirvelu

Abstract

Background: There has been an increase in prevalence in cervicogenic headaches (CGH) which is commonly accompanied by neck pain, decreased cervical range of motion (ROM), and other symptoms related to neck movement.

Purpose: The objective of this systematic review was to compare manipulation/mobilization versus dry needling (DN) to determine which treatment is most effective in improving pain intensity, ROM, and frequency in individuals with CGH.

Methods: Current literature was retrieved from a search using Pubmed and EBSCO (Medline) databases. The following keywords were used to guide searches: “cervicogenic” “headache” “neck pain” “dry needling” “manipulation” “mobilization” “manual therapy”. After filtering, 10 studies met inclusion and exclusion criteria such as treatment via manipulation/mobilization or dry needling, diagnosis of CGH, no other treatments or headache diagnoses were the focus of the study, or outcome measures not aligned with our purpose. All studies were appraised by 2 raters using the PEDro scale, and PRISMA guidelines were followed.

Results: Of the 1,406 identified studies, 10 randomized control trials were eligible for review. Only 7 studies met our threshold for quality on the Pedro scale (≥ 5). Two studies of good quality and one of fair quality suggested that DN was an effective treatment; two studies of good quality suggested that manipulation was significantly better than placebo and mobilization; one good quality study suggested that mobilizations worked significantly better than placebo but had a small effect size; and one good quality study suggested that manipulation combined with DN was significantly effective as treatment. Positive treatment benefits for DN were evident immediately after treatment and persisted for up to 6 months, whereas manipulation was evident immediately and for up to 3 months due to the length of the study. The analysis of the data revealed that DN and manipulations significantly improved headache frequency, intensity, and cervical range of motion. However, more research is necessary to establish if a single treatment is sufficient or whether a mix of treatments is more effective.

Conclusion: This systematic review found both dry needling and manual therapy techniques as effective treatment methods when treating individuals with cervicogenic headaches. However, due to limited research directly comparing the two treatment methods no treatment is found to be superior than the other for improving pain intensity, cervical ROM, and frequency in patients with cervicogenic headaches.

Download

Share

COinS