Abstract
Cervicogenic headache is a disorder that is gaining more recognition in the medical field annually. Although a lot of controversy surrounds cervicogenic headache due to its wide array of symptoms and overlap with pre-existing primary headaches, there are many etiologies and treatment procedures that currently exist.
The aim of this study was to determine the most effective treatment protocol for cervicogenic headache by comparing three different research trials from the University of Johannesburg Chiropractic day clinic (former Technikon Witwatersrand Chiropractic day clinic) within a two-year period. The treatment protocols that were compared were cervical spinal manipulative therapy, a combination of cervical spinal manipulative therapy and cervical strengthening exercises, temporomandibular joint manipulative therapy and postural correction of the lumbar spine to decrease anterior head carriage.
Seventy-eight participants from a possible 96 candidates were contacted telephonically and asked verbal consent to participate in the research trial. The participants were required to complete a telephonic questionnaire that was drawn up by the researcher involved with the aid of a statistical consultant. The questionnaire took 5 minutes to complete.
The aim of the questionnaire was to assess the percentage of participants who were currently suffering from headache and the severity, duration and frequency of their headaches. Participants also needed to compare their current and previous headaches.
The data was statistically analysed using cross tabulations and CHI squared tests. Statistical significance was calculated using Fischer’s exact test and Phi test for the two-by-two tables, while the Pearson test and Cramer’s V test was performed on tables larger than two-by-two.
Statistical analysis revealed that the manipulation groups provided relief for up to three months, after which, symptoms recurred. The group that received the Easy Back Postural Correction Device showed the greatest improvement of symptoms in terms of headache free duration and decrease in current headache severity, duration and frequency.
It can thus be concluded that postural correction of the lumbar spine, which in turn corrects anterior head translation, is the treatment of choice for cervicogenic headache.
Dr. M. Moodley
Dr. R. van Zyl