Manual therapies for pain relief in patients with headache

2015 ◽  
Vol 23 (1) ◽  
pp. 89-96
Author(s):  
Débora Wanderley ◽  
Andrea Lemos ◽  
Larissa de Andrade Carvalho ◽  
Daniella Araújo de Oliveira
Keyword(s):  
Treatment Effect ◽  
Cervicogenic Headache ◽  
Allocation Concealment ◽  
Tension Type Headache ◽  
Manual Therapies ◽  
Osteopathic Manipulation ◽  
Intention To Treat ◽  
Headache Relief ◽  
Type Headache ◽  
Treat Analysis

Objective. This systematic review aimed to assess the efficacy of manual therapies for headache relief. Method. A systematic search in MEDLINE, LILACS, Cochrane, CINAHL, Scopus and Web of Sci­ence databases was conducted for randomized and quasi-randomized trials, with no restrictions for language or year of publication. The de­scriptors were ‘Headache’, ‘Headache disorders’ and ‘Musculoskeletal manipulations’, in addition to the keyword ‘Manual therapy’ and its equivalents in Portuguese. We included studies that compared mas­sage, chiropractic manipulation, osteopathic manipulation and other spinal manipulation to groups with no intervention, other physiother­apeutic modalities or to a sham group. Results. Seven of the 567 ar­ticles initially screened were selected, including patients with tension type headache, cervicogenic headache or migraine. It was not possible to assess the magnitude of the treatment effect on the findings of this review. The main limitations were the absence of randomization and adequate allocation concealment, the lack of blinded evaluators and intention-to-treat analysis and inadequate statistical analysis. Conclu­sions. We were unable to determine the size of the treatment effect due to the selective description of findings. Owing to the high risk of bias in the articles included, the available evidence regarding the ef­ficacy of manual therapies for headache relief is insufficient.

Low-Dose Ibuprofen in Self-Medication of Mild to Moderate Headache: A Comparison with Acetylsalicylic Acid and Placebo

Cephalalgia ◽  
1995 ◽  
Vol 15 (6) ◽  
pp. 531-535 ◽  
Author(s):  
J Nebe ◽  
M Heier ◽  
HC Diener
Keyword(s):  
Acetylsalicylic Acid ◽  
Low Dose ◽  
Tension Type Headache ◽  
Self Medication ◽  
Double Blind ◽  
Over The Counter ◽  
Intention To Treat ◽  
Type Headache ◽  
Treat Analysis ◽  
Observation Period

A double-blind, threefold crossover, double-dummy trial was performed, investigating the efficacy of 200 mg ibuprofen compared with 500 mg acetylsalicylic acid and placebo in patients who usually treated their headaches with over-the-counter drugs. Ninety-five patients suffering from mild to moderate migraine or episodic tension-type headache were included. Seventy-seven patients entered the intention-to-treat analysis and 65 completed all three treatments. For the main response criterion, a minimum 50% decrease of headache intensity on a visual analogue scale at I h after treatment, ibuprofen was significantly superior to acetylsalicylic acid and placebo. This was true for migraine attacks and tension-type headache episodes. Towards the end of the observation period (150 min), the differences between ibuprofen and acetylsalicylic acid were no longer significant. In conclusion, ibuprofen was at least equivalent to acetylsalicylic acid and superior to placebo.

The Reproducibility of Cephalic Pain Pressure Thresholds in Control Subjects and Headache Patients

Cephalalgia ◽  
1997 ◽  
Vol 17 (7) ◽  
pp. 748-755 ◽  
Author(s):  
T Sand ◽  
JA Zwart ◽  
G Helde ◽  
G Bovim
Keyword(s):  
Pain Intensity ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Control Subjects ◽  
Cephalic Pain ◽  
Type Headache ◽  
The Right ◽  
Headache Patients

Pain pressure thresholds (PPT) were measured at 13 cephalic points bilaterally in 30 headache patients (10 with tension-type headache, 10 with migraine and 10 with cervicogenic headache) and 10 control subjects on three different days. During the sessions, the subjects reported their pain intensity on the right and left sides of the head on a visual analogue scale (VAS). The variability between days was estimated as a coefficient of repeatability (CR=2 standard deviations of intraindividual differences). The mean CR across all 13 locations was larger in headache patients (2.0 kg/cm2) than in controls (1.68 kg/cm2). Variability (CR) was larger in headache patients as compared to control subjects for 11 of the 13 points (p=0.02). Reliability was better in controls (intraclass correlation coefficients (ICC) ranging from 0.55 to 0.85) than in headache patients (ICC ranging from 0.43 to 0.78). A moderate negative association between PPT and pain intensity was demonstrated. The intraindividual PPT difference (PPT on the most painful occasions-PPT on the least painful occasions) was negative at 12 of 13 cephalic points (p=0.003, across-location mean difference: -0.20 kg/cm2). The PPT differed significantly from one day to the next. A part of this variation was presumably related to the circumstances around the procedure; thresholds were lower when the subjects came directly to algometry without any preceding medical examination at all 13 points (p=0.0002). These results have implications for the planning of future algometer studies. The sample size that is required in studies of headache patients is greater than that in studies of healthy subjects, especially when patients suffer from pain during the PPT session. Particular attention should be paid to circumstances (e.g. preceding medical investigations) around the algometry procedure in order to reduce variability.

scholarly journals Greater occipital nerve blockade in migraine, tension-type headache and cervicogenic headache

2002 ◽  
Vol 3 (3) ◽  
pp. 137-141 ◽  
Author(s):  
Tansel Terzi ◽  
Bašak Karakurum ◽  
Serap Üçler ◽  
Levent E. İnan ◽  
Cankat Tulunay
Keyword(s):  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Nerve Blockade ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
Type Headache

Six-month clinical course and factors associated with non-improvement in migraine and non-migraine headaches

Cephalalgia ◽  
2017 ◽  
Vol 38 (10) ◽  
pp. 1672-1686 ◽  
Author(s):  
Maria-Eliza R Aguila ◽  
Trudy Rebbeck ◽  
Alun Pope ◽  
Karl Ng ◽  
Andrew M Leaver
Keyword(s):  
Clinical Course ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Self Report ◽  
Headache Frequency ◽  
Electronic Diary ◽  
Factors Associated ◽  
Migraine Headaches ◽  
Type Headache ◽  
Frequency Intensity

Background Evidence on the medium-term clinical course of recurrent headaches is scarce. This study explored the six-month course and factors associated with non-improvement in migraine compared with tension-type headache and cervicogenic headache. Methods In this longitudinal cohort study, the six-month course of headaches was prospectively examined in participants (n = 37 with migraine; n = 42 with tension-type or cervicogenic headache). Participants underwent physical examination for cervical musculoskeletal impairments at baseline. Participants also completed questionnaires on pain, disability and other self-report measures at baseline and follow-up, and kept an electronic diary for 6 months. Course of headaches was examined using mixed within-between analyses of variance and Markov chain modeling. Multiple factors were evaluated as possible factors associated with non-improvement using regression analysis. Results Headache frequency, intensity, and activity interference in migraine and non-migraine headaches were generally stable over 6 months but showed month-to-month variations. Day-to-day variations were more volatile in the migraine than the non-migraine group, with the highest probability of transitioning from any headache state to no headache (probability = 0.82–0.85). The odds of non-improvement in disability was nearly six times higher with cervical joint dysfunction (odds ratio [95% CI] = 5.58 [1.14–27.42]). Conclusions Headache frequency, intensity, and activity interference change over 6 months, with day-to-day variation being more volatile in migraine than non-migraine headaches. Cervical joint dysfunction appears to be associated with non-improvement for disability in 6 months. These results may contribute to strategies for educating patients to help align their expectations with the nature of their headaches.

Manual Therapies in the Management of Tension-Type Headache

2005 ◽  
Vol 45 (2) ◽  
pp. 169-171 ◽  
Author(s):  
Cesar Fernández-de-las-Peñas ◽  
Cristina Alonso-Blanco ◽  
Maria Luz Cuadrado ◽  
Juan Carlos Miangolarra ◽  
Francisco Javier Barriga ◽  
...  
Keyword(s):  
Tension Type Headache ◽  
Manual Therapies ◽  
Type Headache

Cerebrospinal Fluid Cytokine Levels in Migraine, Tension-Type Headache and Cervicogenic Headache

Cephalalgia ◽  
2009 ◽  
Vol 29 (3) ◽  
pp. 365-372 ◽  
Author(s):  
SH Bø ◽  
EM Davidsen ◽  
P Gulbrandsen ◽  
E Dietrichs ◽  
G Bovim ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Migraine With Aura ◽  
Transforming Growth Factor ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Significant Group ◽  
Significant Difference ◽  
Cytokine Levels ◽  
Type Headache ◽  
Tgf Β1

Cytokines have been measured in cerebrospinal fluid (CSF) from headache patients [infrequent episodic tension-type headache (TTH) and migraine with or without aura, all during attack, and cervicogenic headache] and compared with levels in pain-free individuals. Both proinflammatory [interleukin (IL)-1β, tumour necrosis factor-α and monocyte chemoattractant protein-1 (MCP-1)] and anti-inflammatory cytokines IL-1 receptor antagonist (IL-1ra), IL-4, IL-10 and transforming growth factor-β1 (TGF-β1)] were included. There were significant group differences in IL-1ra, TGF-β1 and MCP-1 in episodic TTH and migraine compared with controls, and a significant difference in MCP-1 between cervicogenic headache and migraine with aura. Intrathecal MCP-1 correlated with IL-1ra, IL-10 and TGF-β1 in episodic TTH, and MCP-1 with IL-10 in migraine with aura. Cytokine increases were modest compared with those often accompanying serious neurological conditions, and may represent a mild response to pain. We believe this to be the first comparative study of CSF cytokine levels in connection with headache.

Definitions and participant characteristics of frequent recurrent headache types in clinical trials: A systematic review

Cephalalgia ◽  
2017 ◽  
Vol 38 (4) ◽  
pp. 786-793 ◽  
Author(s):  
Maria-Eliza R Aguila ◽  
Trudy Rebbeck ◽  
Kristofferson G Mendoza ◽  
Mary-Grace L De La Peña ◽  
Andrew M Leaver
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cluster Headache ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Inclusion Criteria ◽  
Recurrent Headache ◽  
Episode Frequency ◽  
Type Headache

Background Clear definitions of study populations in clinical trials may facilitate application of evidence to clinical populations. This review aimed to explore definitions of study populations in clinical trials on migraine, tension-type headache, cluster headache, and cervicogenic headache. Methods We performed a systematic review of clinical trials investigating treatment efficacy for migraine, tension-type headache, cluster headache, and cervicogenic headache. We extracted data on diagnosis, inclusion criteria and baseline headache characteristics. Results Of the 229 studies reviewed, 205 studies (89.5%) defined their populations in adherence to the International Classification of Headache Disorders (ICHD) criteria. Some studies ( n = 127, 55.5%) specified diagnosing through interview, clinical examination and diary entry. The most commonly reported inclusion criteria were pain intensity for migraine and tension-type headache studies ( n = 123, 66.1% and n = 21, 67.7%, respectively), episode frequency ( n = 5, 71.4%) for cluster headache studies, and neck-related pain for cervicogenic headache studies ( n = 3, 60%). Few studies reported details on the extent to which diagnostic criteria were present at baseline. Conclusions ICHD is routinely used in defining populations in headache studies. Details of baseline headache characteristics were not as consistently reported.

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