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A comparison of the presentation of patients with cervicogenic headaches and patients with non-cervicogenic headachesPramod, Abraham 09 September 2014 (has links)
Introduction: Headache is one of the most common disorders of the nervous system and several of its subtypes lead to substantial levels of disability. Cervicogenic headache is a condition characterised by chronic hemi-cranial pain that is referred to the head from either bony structures or soft tissues of the neck. One of the common factors associated with all forms of headaches is the presence of trigger points. The aim of this study was to compare the sensitivity of trigger points, descriptive characteristics and level of disability in patients with cervicogenic and in patients with non-cervicogenic headaches.
Methodology:
The study was conducted as a quantitative, cross sectional, descriptive study. Forty participants (20 with cervicogenic and 20 non-cervicogenic headache) were included into this study sample. The classification of patients as having cervicogenic or non-cervicogenic headache was done according to the guidelines of Zito et al (2006). The sensitivity of trigger points in the upper trapezius, sternocleidomastoid, posterior cervical and temporalis muscles were established using a hand-held digital algometer with 1cm2 round head. Their level of disability was compared using the Henry Ford Headache Disability Inventory (HDI). The demographic and clinical presentation of both the groups was also compared including age, sex, duration of headache and pain rate scale. The above mentioned variables were compared using student t-test and chi-square test.
Results:
Descriptive characteristics, pain intensity and level of disability did not attain a statistical significant difference between the two groups. The results found evidence of a statistically
significant difference with respect to trigger points sensitivity in right upper trapezius (p=0.02) and left upper trapezius (p=0.01). The sensitivity of trigger points of upper trapezius were higher in cervicogenic groups but none of the other muscles tested showed difference in sensitivity between both groups.
Discussion
Similarities in the descriptive characteristics, pain intensity and level of disability of both groups suggest that both types of headaches cannot be differentiated in terms of a specific age, sex, body mass index, pain intensity or level of disability. Increased sensitivity of trigger points especially in upper trapezius may be used as an additional diagnosing factor of cervicogenic headache group.
Conclusion:
The results of this study found that patients with cervicogenic headache had an increased sensitivity of the upper trapezius muscles compared to patients with non-cervicogenic headache. Since physiotherapists play an important role in the treatment of trigger points the value of physiotherapy treatment in the management of cervicogenic headache releasing the trigger points in the upper trapezius may result in a decrease in symptoms and an associated improvement in quality of life.
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