Investigating the Effect of Pain Neurophysiology Education in the Treatment of Cervicogenic Headache: A Randomized Clinical Trial

Abstract

Background: Cervicogenic headaches that stem from musculoskeletal disorders of the upper cervical spine are among the most common types of chronic headaches. In recent years, physiotherapy has emerged as a potential treatment for this type of headache. Objectives: Given the emphasis on educational methods such as pain neurophysiology education (PNE) for musculoskeletal pain, the aim of this study is to investigate the effect of PNE in treating cervicogenic headaches. Methods: This study was a single-blind clinical trial. A sample of 30 participants with cervicogenic headache was divided into two groups using the block method: An experimental group of 15 participants and a control group of 15 participants. Experienced physiotherapists provided conventional physiotherapy for 10 sessions, and the experimental group also received pain neurophysiology education for four additional sessions. Pain severity, disability, and pain catastrophizing information were collected using the visual analog scale, headache disability index, and pain catastrophizing scale, respectively, at the beginning of the study, after the study, and at the one-month follow-up. Statistical analysis was conducted using SPSS software version 22, and the significance level was set at 0.05. Results: A significant difference was observed in pain intensity assessment at different times (P < 0.001), headache disability index (P = 0.003), and pain catastrophizing (P < 0.001). The time-by-group interaction was significant for pain intensity (F = 49.051; P < 0.001; ηp2=0.637) and pain catastrophizing (F = 25.528; P < 0.001; ηp2=0.477); however, there was no significant difference in disability (F = 1.781; P = 0.178; ηp2=0.060). Conclusions: Pain neurophysiology education can have a positive effect on pain reduction, as well as the attitude and knowledge of individuals who experience pain in the short term.