Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multicenter randomized clinical trial

Dunning, James; Butts, Raymond; Zacharko, Noah; Fandry, Keith; Young, Ian; Wheeler, Kenneth; Day, Jennell; Fernández‐de‐las‐Peñas, César

doi:10.1016/j.spinee.2020.10.008

Cited by 16 publications

(19 citation statements)

References 74 publications

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“…The RoB analysis showed high inter-rater reliability (Cohen’s Kappa = 0.87). Overall RoB was low in eight trials [ 53 , 55 , 56 , 60 , 61 , 66 – 68 ], unsure in six trials [ 51 , 58 , 62 – 64 , 69 ], and high in six trials [ 52 , 54 , 57 , 59 , 65 , 70 ] for the primary and secondary outcome measures. Further detail regarding the RoB of individual studies is found in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis

et al. 2022

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Background Cervicogenic headache is a secondary headache, and manual therapy is one of the most common treatment choices for this and other types of headache. Nonetheless, recent guidelines on the management of cervicogenic headache underlined the lack of trials comparing manual and exercise therapy to sham or no-treatment controls. The main objective of this systematic review and meta-analysis was to assess the effectiveness of different forms of manual and exercise therapy in people living with cervicogenic headache, when compared to other treatments, sham, or no treatment controls. Methods Following the PRISMA guidelines, the literature search was conducted until January 2022 on MEDLINE, CENTRAL, DOAJ, and PEDro. Randomized controlled trials assessing the effects of manual or exercise therapy on patients with cervicogenic headache with headache intensity or frequency as primary outcome measures were included. Study selection, data extraction and Risk of Bias (RoB) assessment were done in duplicate. GRADE was used to assess the quality of the evidence. Results Twenty studies were included in the review, with a total of 1439 patients. Common interventions were spinal manipulation, trigger point therapy, spinal mobilization, scapulo-thoracic and cranio-cervical exercises. Meta-analysis was only possible for six manual therapy trials with sham comparators. Data pooling showed moderate-to-large effects in favour of manual therapy for headache frequency and intensity at short-term, small-to-moderate for disability at short-term, small-to-moderate for headache intensity and small for headache frequency at long-term. A sensitivity meta-analysis of low-RoB trials showed small effects in favor of manual therapy in reducing headache intensity, frequency and disability at short and long-term. Both trials included in the sensitivity meta-analysis studied spinal manipulation as the intervention of interest. GRADE assessment showed moderate quality of evidence. Conclusion The evidence suggests that manual and exercise therapy may reduce headache intensity, frequency and disability at short and long-term in people living with cervicogenic headache, but the overall RoB in most included trials was high. However, a sensitivity meta-analysis on low-RoB trials showed moderate-quality evidence supporting the use of spinal manipulation compared to sham interventions. More high-quality trials are necessary to make stronger recommendations, ideally based on methodological recommendations that enhance comparability between studies. Trial registration The protocol for this meta-analysis was pre-registered on PROSPERO under the registration number CRD42021249277.

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Section: Resultsmentioning

confidence: 99%

The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis

et al. 2022

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“…Although physiotherapy with dry needling and electrical dry needling has proven positive effects on chronic low back pain [ 22 – 31 ], the results of studies into the duration of the analgesic effect and the dose required, for example, are contradictory [ 61 , 62 ]. Therefore, further research is required to evaluate the specific components of the treatments administered by physical therapists.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Dry needling is typically used to treat soft tissues, such as muscles, ligaments, tendons, fascia, scar tissue, peripheral nerves and neurovascular bundles involved in a variety of neuromusculoskeletal pain syndromes [ 21 , 22 ]. Dry needling involves the insertion of fine monofilament needles without the use of injectables, and its therapeutic effect is based on stimulating specific reactions in the target tissue [ 23 – 27 ].…”

Section: Introductionmentioning

confidence: 99%

Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain

Lara‐Palomo

Gil-Martínez

Antequera-Soler

et al. 2022

Trials

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Background Chronic low back pain is considered to be one of the main causes of absenteeism from work and primary and specialized consultations. The symptoms of nonspecific chronic low back pain may be accompanied by the activation of myofascial trigger points in the muscles, together with local and/or referred pain. Electrical dry needling is increasingly used in the treatment of lumbar myofascial pain. Conventional physiotherapy, however, is a popular approach to chronic pathologies, and there is evidence of different modalities of physiotherapy being used in the treatment of chronic low back pain. The aim of this study has been to determine the effectiveness of electrical dry needling versus conventional physiotherapy when applied to active and latent myofascial trigger points in patients with nonspecific chronic low back pain. Methods This is a controlled, randomized, two-arm, double-blind study. A total of 92 patients with chronic low back pain (time to onset ≥ 3 months, Roland Morris Disability Questionnaire score ≥ 4) will be recruited from the University of Almería. Participants will be divided into two study groups (n = 40) to receive treatment of low back pain with electrical dry needling and conventional physiotherapy (ischaemic compression, analytic stretching and postural education training dossier). A total of 6 sessions will be administered once a week for 6 weeks. Pain intensity, disability, fear of movement, quality of life, quality of sleep, anxiety and depression, pressure pain threshold, abdominal strength and lumbar mobility will be recorded at 6 weeks (post-immediate) and 2 months after the end of treatment. Discussion We believe that an approach including electrical dry needling to chronic low back pain dysfunction will be more effective in these patients. The results of this study will inform clinicians on which type of treatment is more beneficial for patients with chronic low back pain. Trial registration ClinicalTrials.gov NCT04804228. Registered on 14 January 2021

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“…[ 7 , 8 ] Among them, acupuncture and massage as a part of traditional Chinese medicine therapy have gradually become the research hotspot [ 8 ] of treating this disease because of their advantages of loosening adhesion, effectively relieving muscle spasm, reducing pain and local pressure, and small side effects. Multiple traditional studies [ 9 – 12 ] have confirmed the significant clinical efficacy of acupuncture or massage in CGH, based on this, we explore whether acupuncture combined with massage has better efficacy compared with other therapies. In this study, the purpose of this systematic review was to assess the effectiveness and safety of acupuncture combined with massage for CGH and to provide evidence for clinical decision-making.…”

Section: Introductionmentioning

confidence: 99%

Acupuncture plus massage for cervicogenic headache

Ding

Liu

et al. 2022

Medicine

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Background: Cervicogenic headache (CGH), one of the most common headaches. It is characterized by pain starting from the neck and gradually involving the eyes, frontal and temporal regions. Acupuncture and massage therapy has been widely used in the treatment of CGH, the purpose of this study was to evaluate the effectiveness and safety of acupuncture combined with massage in the treatment of CGH. Methods: The databases of PubMed, Embase, Cochrane library, Medicine, Web of Science, China National Knowledge Infrastructure, Wan-Fang Database, China Biomedical Literature Service System, and Chongqing VIP Chinese Science will be searched. This study will include randomized controlled trials of acupuncture combined with massage in the treatment of CGH published before November 2021. The primary outcomes included the overall efficiency, visual simulation score, neck activity score, quality of life score, and adverse reactions as secondary outcomes were assessed. Cochrane bias risk assessment tool will be used for literature data screening and quality evaluation, and using RevMan5.4 to collect data for statistical analysis. We then will use the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the overall quality of evidence supporting the primary outcomes. Results: This systematic review will provide a high-quality synthesis to evaluate the efficacy and safety of acupuncture combined with massage therapy in the treatment of CGH, providing a reference for the safe and effective treatment plan. Conclusion: This study provides evidence that acupuncture combined with massage is effective and safe for patients with CGH. Systematic review registration: INPLASY2021120049U1.

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Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multicenter randomized clinical trial

Cited by 16 publications

References 74 publications

The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis

The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis

Electrical dry needling versus conventional physiotherapy in the treatment of active and latent myofascial trigger points in patients with nonspecific chronic low back pain

Acupuncture plus massage for cervicogenic headache

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