Ischemic Compression Technique Versus Jones Technique in Cervicogenic Headache Patients

NCT ID: NCT06875869

Last Updated: 2025-03-13

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 32 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-01-02
• Study Completion Date: 2025-09-15

Brief Summary

The primary objective of the study is to determine the effects of Jones and Ischemic compression technique on pain, range of motion and disability in patients with cervicogenic headache. Cervicogenic headache is a distinctive type of secondary headache where the pain originates from structures in the neck or cervical spine and radiates to the head. Trigger point release has been associated with decrease in symptoms of patients with cervicogenic headache. This study will be a randomized clinical trial with the sample size of 32 patients. Participants will be randomly allocated into two groups: Group A and Group B. The setting of the study will be Bahawal Victoria Hospital, Bahawalpur. Group A will receive Jones technique of trigger points of the upper trapezius and sternocleidomastoid muscle while Group B will receive ischemic compression of the trigger points of the upper trapezius and sternocleidomastoid muscle. Patients of both groups will receive two treatment sessions per week for 6 weeks. Both groups will receive hot pack for 10 minutes, TENS for 15 minutes and strengthening exercises for deep neck flexors (chin tuck and head raise with ten repetitions of 10-second duration, with a 10-second rest interval between each contraction) as baseline treatment protocol. NPRS, HDI and FRT will be used as outcome measure tools. Data will be analyzed using SPSS version 25.0 with the p-value of <0.05 taken as significant difference.

Detailed Description

Cervicogenic headache (CGH) is a secondary headache caused by a disorder of the cervical spine and its disc or bony and/or periarticular components and is often accompanied by neck pain The prevalence cervicogenic headache of in the general population has been reported to be 2.2%-4.1% and appears to predominate in women four times more than in men. Noninvasive treatment techniques consist mainly of electrotherapy, manual therapy (MT), and exercise prescription. Myofascial Trigger Point (MTrP) activity is one of the leading causes of CGH. Jones technique and Ischemic compression ( IC) are two treatment options for trigger points. Cervicogenic headaches are a growing problem impacting daily life, research on cervicogenic headaches is crucial to understand the link between neck issues and headaches, and develop more effective long-term treatment options. In view of the above, the current study aims to evaluate the effectiveness of Physiotherapy interventions i.e. Jones and Ischemic compression technique for Myofascial Trigger Points (MTrPs) of Sternocleidomastoid and upper Trapezius in treating cervicogenic headache.

The current study will help us in determining whether use of these techniques has any significant advantage over conventional treatment for pan and disability in CGH patients. Understanding the most effective therapeutic approach can guide practitioners in selecting evidence-based interventions, ultimately improving the overall well-being of patients suffering from cervicogenic headache.

Conditions

Cervicogenic Headache

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Group-A (Jones technique)

Patients will receive Jones technique for the Sternocleidomastoid and upper fibers of Trapezius.

Group Type: EXPERIMENTAL

Jones technique

Intervention Type: OTHER

In the Jones technique, pressure will be applied on the tender point and the patient's head will be flexed laterally to the side of the tender point, followed by a shoulder abduction of approximately 90 degrees. This position will be held for 90 s and then patient position will be passively returned to the initial position. This will be repeated three times in each session. Patients will receive two treatment sessions per week for 6 weeks

Group-B (Ischemic compression therapy)

Patients will receive Ischemic compression for the Sternocleidomastoid and upper fibers of Trapezius

Group Type: ACTIVE_COMPARATOR

Ischemic compression therapy

Intervention Type: OTHER

Patients will receive ischemic compression of the trigger points of the upper trapezius and sternocleidomastoid muscle with hold time varying between 30 seconds to 1 minute repeated 3 to 5 times in each session. Patients will receive two treatment sessions per week for 6 weeks

Interventions

Jones technique

In the Jones technique, pressure will be applied on the tender point and the patient's head will be flexed laterally to the side of the tender point, followed by a shoulder abduction of approximately 90 degrees. This position will be held for 90 s and then patient position will be passively returned to the initial position. This will be repeated three times in each session. Patients will receive two treatment sessions per week for 6 weeks

Intervention Type: OTHER

Ischemic compression therapy

Patients will receive ischemic compression of the trigger points of the upper trapezius and sternocleidomastoid muscle with hold time varying between 30 seconds to 1 minute repeated 3 to 5 times in each session. Patients will receive two treatment sessions per week for 6 weeks

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Both males and females
• 25-35 years of age
• Individuals satisfying the Cervicogenic Headache criteria
• Positive Simon's criteria for trigger points

Exclusion Criteria

• primary headaches (i.e., migraine, tension type headache)
• bilateral headache
• Presence of any red flags
• cervical spinal stenosis
• evidence of central nervous system involvement
• prior surgery to the head or neck

• Minimum Eligible Age: 25 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Ghulam Fatima, PHD*

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Bahaval Victoria Hospital

Bahawalpur, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Imran Amjad, PHD*

Role: CONTACT

imran.amjad@riphah.edu.pk

03324390125

Imran Amjad, PHD*

Role: CONTACT

imran.amjad@riphah.edu.pk

0515481826

Facility Contacts

Ghulam Fatima, PhD*

Role: primary

ghulam.fatima@riphah.edu.pk

03034073057

References

Page P. Cervicogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther. 2011 Sep;6(3):254-66.

Reference Type: BACKGROUND

PMID: 22034615 (View on PubMed)

Knackstedt H, Bansevicius D, Aaseth K, Grande RB, Lundqvist C, Russell MB. Cervicogenic headache in the general population: the Akershus study of chronic headache. Cephalalgia. 2010 Dec;30(12):1468-76. doi: 10.1177/0333102410368442. Epub 2010 May 19.

Reference Type: BACKGROUND

PMID: 20974607 (View on PubMed)

Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. Lancet Neurol. 2009 Oct;8(10):959-68. doi: 10.1016/S1474-4422(09)70209-1.

Reference Type: BACKGROUND

PMID: 19747657 (View on PubMed)

Garcia JD, Arnold S, Tetley K, Voight K, Frank RA. Mobilization and Manipulation of the Cervical Spine in Patients with Cervicogenic Headache: Any Scientific Evidence? Front Neurol. 2016 Mar 21;7:40. doi: 10.3389/fneur.2016.00040. eCollection 2016.

Reference Type: BACKGROUND

PMID: 27047446 (View on PubMed)

Olesen J. International Classification of Headache Disorders. Lancet Neurol. 2018 May;17(5):396-397. doi: 10.1016/S1474-4422(18)30085-1. Epub 2018 Mar 14. No abstract available.

Reference Type: BACKGROUND

PMID: 29550365 (View on PubMed)

Other Identifiers

REC/RCR & AHS/24/0152

Identifier Type: -

Identifier Source: org_study_id