Are non-invasive interventions effective for the management of headaches associated with neck pain? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration

Abstract

The management of headaches associated with neck pain should include exercise. Patients who suffer from chronic tension-type headaches may also benefit from relaxation training with stress coping therapy or multimodal care. Patients with cervicogenic headache may also benefit from a course of manual therapy.

Non‐pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration

“…The Guideline Expert Panel did not recommend these interventions to minimize the risk of iatrogenic disability in patients with neck pain (Cassidy, Carroll, Côté, & Frank, ; Côté et al, ; Côté & Soklaridis, ). We found inconclusive evidence on the effectiveness of needle acupuncture for the management of tension‐type headaches because the results of multiple high‐quality RCTs conflicted with each other (Varatharajan et al, ). The guideline does not recommend passive physical modalities, stand‐alone structured patient education or work disability prevention interventions because their effectiveness has not been evaluated in high‐quality studies (Varatharajan et al, ).…”

“…We updated the systematic reviews from the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders (Hurwitz et al, ). This update included six systematic reviews (published in one article) examining the effectiveness and safety of non‐invasive interventions for the management of headaches associated with neck pain (Varatharajan et al, ). We also conducted one systematic review examining cost‐effectiveness of the non‐invasive interventions (data extraction completed but not published).…”

“…The OPTIMa Collaboration developed the guideline using the principles of patient‐centred care and the Ontario Health Technology Advisory Committee framework (Johnson et al, ). Specifically, we developed the evidence‐based recommendations according to the following: Overall clinical benefits (i.e., effectiveness and safety of interventions based on our systematic reviews) (Varatharajan et al, ); Value for money (i.e., cost‐effectiveness of interventions when available based on our systematic review); Consistency with expected societal and ethical values (including persons’ lived experiences with their treatment based on our qualitative research) (Lindsay, Mior, Côté, Carroll, & Shearer, ). …”

“…The clinical management of headaches associated with neck pain is often challenging. Evidence suggests that cervical spine exercises or manual therapy may be effective in the management of tension‐type or cervicogenic headaches (Varatharajan et al, ). Moreover, available clinical practice guidelines recommend that reassurance, acupuncture, exercise, physical therapy (e.g., massage, spinal manipulation, hot and cold packs, ultrasound and electrical stimulation) and psychological interventions can be used to treat tension‐type headaches (Becker, Findlay, Moga, Scott, & Harstall, ; Bendtsen et al, ; Carville, Padhi, Reason, Underwood, & Group, ).…”

Refining scapulothoracic kinematic measurement and characterising scapulothoracic resting posture in those with and without chronic non-specific neck pain

“…Other studies have reported a high correlation (r = 0.67-0.83) between neck disability (evaluated using the Neck Disability Index (NDI) and the Northwick Park Neck Pain Questionnaire (NPQ)) and disability of the upper limb (evaluated using the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire (Huisstede et al, 2009;Mehta et al, 2010;Osborn and Jull 2013) indicating a relationship between neck pain and upper limb disability. Although the exact mechanism between impaired upper limb function and neck pain has not been extensively researched, studies investigating the efficacy of exercise for the treatment of neck pain and headaches usually include shoulder girdle and upper limb exercises in their exercise protocols (Amorim et al, 2014;Ang et al, 2009;Bronfort et al, 2001;Franca et al, 2008;Jull et al, 2002;Kay et al, 2012;Varatharajan et al, 2016). To understand how upper limb function (or dysfunction) may affect the neck region and potentially result in neck pain, it is necessary to consider the anatomical connection between these two regions.…”