Research Database -
International Updates

Headache / Neck Pain

Issue 20

HAMMILL and colleagues, Mercy Medical Center, Cedar Rapids, Iowa USA used a physical therapy regimen to treat muscle contraction headache. METHODS: 20 people with a diagnosis of muscle contraction headache were treated for pain relief with physical therapy once per week for six visits. The control period was the previous 3-week period of no treatment, during which time the people recorded a diary of their headache frequency, duration and intensity using a numeric pain scale. Activity level, measured by the Sickness Impact Profile, and verbal reports of headache frequency, duration and intensity were recorded 4 times during a one-year period. Measurements were recorded at precontrol, pretreatment, posttreatment and 12-month follow-up. The physical therapy treatment included education for posture at home and work, isotonic home exercise, massage and stretching the cervical spine muscles. RESULTS: The frequency of headaches and Sickness Impact Profile scores significantly improved over the course of treatment, and these benefits were maintained after 1 year.
Hammill JM et al. Effectiveness of a physical therapy regimen in the treatment of tension-type headache. Headache 36(3): 149—53. Mar 1996.

LARSSON and CARLSSON, Centre for Caring Sciences, Uppsala University, Sweden compared the clinical efficacy of a school-based relaxation training intervention administered by a nurse to a no-treatment control for children aged 10—15 years suffering from chronic tension headache. METHODS: 26 children were randomly assigned to either relaxation or no-treatment groups. Outcome results were recorded at post-treatment and at 6 months follow-up. RESULTS: Compared to the control group, headache activity in the relaxation training group was significantly more reduced at post-treatment and at 6 months. Of the children treated with relaxation, 69% and 73% at post-treatment and 6 months respectively achieved a clinically significant headache improvement – at least 50% improvement – compared to only 8% and 27% of the control no-treatment pupils. CONCLUSIONS: A school-based, nurse-administered relaxation training programme appears to be a viable treatment approach for children suffering with chronic tension-type headaches.
Larsson B and Carlsson J. A school-based, nurse-administered relaxation training for children with chronic tension-type headache. J Pediatr Psychol 21(5): 603—14. Oct 1996.

COMMENTS: It is indeed heartening to see practical clinical implementation of an invaluable and cost-effective regimen, which will doubtless improve the lives of these children and their families.

GROSS and colleagues, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario Canada review (60 references) the use of manual therapies for mechanical neck pain. RESULTS and CONCLUSIONS: Although manual therapies have been shown to be effective for mechanical neck pain in the short term when used in combination with other treatments, no one treatment protocol has been demonstrated to be optimal. Specific types of manual therapies have not been investigated in detail and safety is a prime consideration in the application of these treatment. Risk of increased symptoms from manual therapy is low – 1—2% – the most common symptom aggravation being vertigo or dizziness. Risk of serious complication or death from neck manipulation is extremely low – 0.0001%. Optimal levels of education, training and competence are vital to the safe application of manual therapy.
Gross AR et al. Manual therapy in the treatment of neck pain. Rheum Dis Clin North Am. 22(3): 579—98. Aug 1996.