Postural physiotherapy for cervicogenic headache after occipital nerve block: a retrospective study
DOI:
https://doi.org/10.33448/rsd-v10i12.19994Keywords:
Secondary headache; Physiotherapy; Nerve block.Abstract
Cervicogenic headache has a complex and poorly understood pathophysiology. Symptoms are typical and involve the C2 and C3 nerve roots. There are no specific recommendations for physical therapy, although occipital nerve block is a known pharmacological treatment. Some evidence suggests that hip rotation correction could aid in reducing cervical pain symptoms. The objective of this work is to evaluated the role of postural physiotherapy for hip rotation correction using the Maitland technique in patients with cervicogenic headache who underwent an occipital nerve block. In this retrospective, observational and uncontrolled study, patients were evaluated from January 2017 to February 2018. After diagnosis of cervicogenic headache they underwent anesthetic block, hip radiography with lower limb scanometry and cervical tomography, after which they were referred to physical therapy. The analog pain scale was used for evaluation at the time of diagnosis and after the proposed physiotherapy. Patients submitted to an occipital nerve block were divided into three groups: Group I (n = 15, physical therapy with Maitland technique) had an analog pain score of 1.6 after the physical therapy, Group II (n = 11, conventional physiotherapy) had an analog pain score of 3.7 after the physical therapy and Group III (n = 13, occipital nerve block only) had an analog pain score of 5.2 after the occipital nerve block. The results suggest that an occipital nerve block in combination with the Maitland technique is superior in patients with cervicogenic headache compared to nerve block only or blockade combined with non-specific physical therapy (p=0,013).
References
Antonaci, F., & Inan, L. E. (2021). Headache and neck. Cephalalgia, 41(4), 438–442. https://doi.org/10.1177/0333102420944878
Barmherzig, R., & Kingston, W. (2019). Occipital Neuralgia and Cervicogenic Headache: Diagnosis and Management. Current Neurology and Neuroscience Reports, 19(5), 20. https://doi.org/10.1007/s11910-019-0937-8
Bartschi-Rochaix, W. (1968). Headaches of cervical origin. In Handbook of Clinical Neurology. Vol. 5 Headache and cranial neuralgia (pp. 192–203). North Holland Publishing Company.
Becker, W. J. (2010). Cervicogenic Headache: Evidence That the Neck is a Pain Generator. Headache: The Journal of Head and Face Pain, 50(4), 699–705. https://doi.org/10.1111/j.1526-4610.2010.01648.x
Blumenfeld, A., & Siavoshi, S. (2018). The Challenges of Cervicogenic Headache. Current Pain and Headache Reports, 22(7), 47. https://doi.org/10.1007/s11916-018-0699-z
Carvalho, D. de S. (2019). Síndrome da Cefaléia Cervicogênica. Revista Neurociências, 9(2), 57–59. https://doi.org/10.34024/rnc.2001.v9.8920
Correia, C., & Monteiro, P. (1992). Cefaleia Cervicogênica. Acta Médica Portuguesa, 5(3), 155–158.
Côté, P., Yu, H., Shearer, H. M., Randhawa, K., Wong, J. J., Mior, S., Ameis, A., Carroll, L. J., Nordin, M., Varatharajan, S., Sutton, D., Southerst, D., Jacobs, C., Stupar, M., Taylor‐Vaisey, A., Gross, D. P., Brison, R. J., Paulden, M., Ammendolia, C., & Lacerte, M. (2019). Non‐pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. European Journal of Pain, 23(6), 1051–1070. https://doi.org/10.1002/ejp.1374
Dach, F., Éckeli, Á. L., Ferreira, K. dos S., & Speciali, J. G. (2015). Nerve Block for the Treatment of Headaches and Cranial Neuralgias - A Practical Approach. Headache: The Journal of Head and Face Pain, 55, 59–71. https://doi.org/10.1111/head.12516
Fredriksen, T. A., Hovdal, H., & Sjaastad, O. (1987). “Cervicogenic Headache”: Clinical Manifestation. Cephalalgia, 7(2), 147–160. https://doi.org/10.1046/j.1468-2982.1987.0702147.x
Gallagher, R. M. (2007). Cervicogenic headache. Expert Review of Neurotherapeutics, 7(10), 1279–1283. https://doi.org/10.1586/14737175.7.10.1279
Internation Headache Society. (2013). International Classification of Headache Disorders.
Karadas, O., Ozturk, B., Ulas, U. H., Kutukcu, Y., & Odabasi, Z. (2012). The Efficacy of Botulinum Toxin in Patients with Cervicogenic Headache: a Placebo-Controlled Clinical Trial. Balkan Medical Journal, 29(2), 184–187. https://doi.org/10.5152/balkanmedj.2012.003
Le Corre, F., & Rageot, E. (2004). Atlas Prático de Osteopatia. Artmed.
Peñas, C. F. de las, Florencio, L. L., Plaza-Manzano, G., & Arias-Buría, J. L. (2020). Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review. International Journal of Environmental Research and Public Health, 17(11), 4126. https://doi.org/10.3390/ijerph17114126
Pereira, A. S., et al. (2018). Metodologia da pesquisa cientifica. [free e-book]. Santa Maria: UAB/NTE/ UFSM. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1
Pfaffenrath, V. (1989). Cervicogenic headache and its differential diagnosis. In Migraine and Other Headaches (pp. 161–177). Parthenon.
Rachid, R., & Pinheiro, L. T. M. (2009). A terapia osteopática manipulativa na cefaleia cervicogênica. Revista Brasileira de Promoção Da Saúde, 22(2), 128–134.
Sakata, R. K., & Issy, A. M. (2010). Bloqueios para tratamento da dor. Manole.
Sociedade Brasileira para Estudo da Dor. (2017). Cefaleia Cervicogênica.
Xiao, H., Peng, B., Ma, K., Huang, D., Liu, X., Lu, Y., Liu, Q., Lu, L., Liu, J., Li, Y., Song, T., Tao, W., Shen, W., Yang, X., Wang, L., Zhang, X., Zhuang, Z., Liu, H., & Liu, Y. (2019). The Chinese Association for the Study of Pain (CASP): Expert Consensus on the Cervicogenic Headache. Pain Research and Management, 2019, 1–6. https://doi.org/10.1155/2019/9617280
Wang, E., & Wang, D. (2014). Treatment of Cervicogenic Headache with Cervical Epidural Steroid Injection. Current Pain and Headache Reports, 18(9), 442. https://doi.org/10.1007/s11916-014-0442-3
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Copyright (c) 2021 Alcântara Ramos de Assis César; Igor Dal Pozzo da Costa; Wesley Gabriel Novaes Botelho; Nicole Sperafico; Anderson Dillmann Groto; André Carvalho Felício
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