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OBJECTIVE@#To compare therapeutic effects between nape acupuncture combined with manipulation and simple manipulation in treating cervicogenic headache, and to verify the synergistic effect of manipulation and nape acupuncture.@*METHODS@#Total 60 patients with cervicogenic headache were divided into two groups:nape acupuncture combined with manipulation group (group A) and manipulation group(group B). There were 30 patients in group A, including 12 males and 18 females with an average age of (41.37±12.09) years old, and an average course of disease of (23.73±15.54) months;there were 30 patients in the manipulation group (group B), including 14 males and 16 females with an average age of (42.40±12.05) years old, and an average course of disease of (25.53±14.33) months. In the group A, acupuncture therapy was performed firstly at the bilateral @*RESULTS@#There was no significant difference in the onset time of analgesia between the two groups[(5.97±3.21) min vs(7.30±3.97) min, @*CONCLUSION@#Nape needling can prolong the analgesic time of manipulation and improve the analgesic effect of manipulation.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Acupuncture Points , Acupuncture Therapy , Needles , Post-Traumatic Headache , Treatment OutcomeABSTRACT
The manipulation and key points of professor
Subject(s)
Humans , Acupuncture , Acupuncture Points , Acupuncture Therapy , Headache/therapy , Needles , Post-Traumatic HeadacheABSTRACT
Background: The International Headache Society (IHS), 2013 defined Cervicogenic Headache (CGH) as a secondary headache, which implies that headache is caused by a disorder of the cervical spine and its components bony, disc and soft tissue elements. CGH can be a perplexing pain disorder that is refractory to treatment if it is perceived. Patients with CGH exhibited decreases in the quality of life comparable to migraine-patients and patients with tension-type headache, with even lower scores for physical functioning. The objective of the study is to see the effectiveness of PRT versus ischemic compression on pressure pain threshold, range of motion, and headache disability in CGH patients. Methods: Total of 60 patients of CGH was taken based on inclusion and exclusion criteria, who were divided into three groups, i.e., PRT GROUP A, Ischemic Compression GROUP B, and CONTROL group GROUP C. Group A received PRT, Group B received Ischemic Compression and Group C received conventional treatment 3 sessions per week for 4 weeks. Results: Significant reduction in Headache disability followed by improved physical functioning measured by Headache disability index, improvement in Pressure pain threshold and measured by Pressure algometer and Range of motion measured by Universal goniometer in the group who received Positional release technique along with conventional treatment. (p < 0.05) Therefore, it is suggested that the Positional release technique reduces Headache disability, Improves Pressure pain threshold and range of motion in college-going students with Cervicogenic headache. Conclusion: PRT is an effective approach to improve the Pressure pain threshold, Headache disability, and Range of motion, thus improving the patient's physical functioning.
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OBJECTIVE@#To investigate the clinical characteristics and mechanism of cervicogenic headache.@*METHODS@#Fifty-seven patients with cervicogenic headache who were treated from May 2013 to December 2017 and had complete imaging data were selected, including 18 males and 39 females with an average age of(43.26±10.39) years old ranging from 20 to 63 years old. The duration of the disease was 4 months to 35 years with a mean of (11.74±9.47) years. The pain situation, iconography and Tinel sign were analyzed.@*RESULTS@#The patients with cervicogenic headache often had bilateral pain. The regions mainly concentrated in the temporal region, with occipital, head or orbit pains. The VAS scores decreased with the duration of the disease. There were many cases of disc herniation(91.30%), vertebral instability(73.91%), atlantoaxial displacement(56.52%), curvature change of cervicogenic vertebra(54.35%). The number of positive Tinel sign points was between 3 and 24 (13.58±5.8) per patient. The number and extent of Tinel sign were significantly different between the affected side and healthy side(<0.05). C₂,₃ facet joints(92.98%), post mastoid(89.47%), occipital concavity(89.47%), C₃,₄ facet joints(84.21%), third occipital nerve(80.70%) were the positive Tinel sign points in patients with cervicogenic headache.@*CONCLUSIONS@#The iconography changes of cervicogenic headache and Tinel sign may contribute to the clinical diagnosis and mechanism of the disease.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Cervical Vertebrae , Post-Traumatic Headache , Spinal NervesABSTRACT
Objective To investigate the clinical efficacy of abdominal acupuncture in treating cervicogenic headache. Method Sixty-three patients meeting the diagnostic criteria of cervicogenic headache were allocated using a random number table: 33 cases to the abdominal acupuncture group and 30 cases to the acupuncture groups. The abdominal acupuncture group of patients received abdominal acupuncture and the acupuncture group of patients, body acupuncture. The therapeutic effects were compared between the two groups of patients after three courses of treatment. The headache index score was recorded at the same time. Result The total efficacy rate was 84.8% in the abdominal acupuncture group and 63.3% in the acupuncture group; there was a statistically significant difference between the two groups (P<0.05). The pain index score decreased significantly in both groups after treatment (P<0.05) and decreased more in the abdominal acupuncture group than in the acupuncture group (P<0.05). Conclusion Abdominal acupuncture is more effective than conventional acupuncture in treating cervicogenic headache. It is a new effective way to clinically treat cervicogenic headache.
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Objective To observe the curative effect of cervicogenic headache(CEH)treatment through the combination of pulse radio frequency(PRF)on the C2 dorsal rootganglion and continuous epidural space block.Methods Sixty patients with CEH in our hospital were randomly divided into groups A and B,30 cases in each group.The group A was treated with combination of PRF on cervical dorsal root ganglion and continuous epidural space block.The group B was treated with PRF on cervical dorsal root ganglion method.The pain VAS scores before treatment and at 1 week,3,6 months after treatment were compared between the two groups.Results Compared with pretreatment,the VSA scores at 1 week,3,6 wonths after treatment in the two groups had statistical difference(P＜0.05),moreover,the VAS score decrease in the group A was better than the group B.All the patients had no nerve and artery injury or infection complications.Conclusion It is safe and effective to treat cervical CEH through the combination of ganglion PRF on the cervical 2 dorsal root and continuous epidural space block.
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Occipital neuralgia is defined by the International Headache Society as paroxysmal shooting or stabbing pain in the dermatomes of the greater or lesser occipital nerve. Various treatment methods exist, from medical treatment to open surgical procedures. Local injection with corticosteroid can improve symptoms, though generally only temporarily. More invasive procedures can be considered for cases that do not respond adequately to medical therapies or repeated injections. Radiofrequency lesioning of the greater occipital nerve can relieve symptoms, but there is a tendency for the pain to recur during follow-up. There also remains a substantial group of intractable patients that do not benefit from local injections and conventional procedures. Moreover, treatment of occipital neuralgia is sometimes challenging. More invasive procedures, such as C2 gangliotomy, C2 ganglionectomy, C2 to C3 rhizotomy, C2 to C3 root decompression, neurectomy, and neurolysis with or without sectioning of the inferior oblique muscle, are now rarely performed for medically refractory patients. Recently, a few reports have described positive results following peripheral nerve stimulation of the greater or lesser occipital nerve. Although this procedure is less invasive, the significance of the results is hampered by the small sample size and the lack of long-term data. Clinicians should always remember that destructive procedures carry grave risks: once an anatomic structure is destroyed, it cannot be easily recovered, if at all, and with any destructive procedure there is always the risk of the development of painful neuroma or causalgia, conditions that may be even harder to control than the original complaint.
Subject(s)
Humans , Anesthetics/therapeutic use , Botulinum Toxins/therapeutic use , Electric Stimulation , Magnetic Resonance Imaging , Nerve Block , Neuralgia/diagnosis , Spinal Nerves/anatomy & histology , Steroids/pharmacologyABSTRACT
ObjectiveTo investigate the clinical efficacy of nape eight needles plus cephalic ashi point acupuncture in treating cervicogenic headache.MethodA randomized controlled trial was carried out. Eighty-nine patients with cervicogenic headache were randomly allocated to two groups, the treatment group of 45 cases and the control group of 44 cases. Nape eight points [bilateral Fengchi(GB20), Fengfu(GV16), Dazhui(GV14) and “nape Sihuaxue”] and cephalic ashi points were selected inthe treatment group and Huatuo jiaji(Ex-B2) points at the affected cervical vertebrae and points Tianzhu(BL10), Fengchi, Yuzhen(BL9), Lieque(LU7), Taichong(LR3)and Zulinqi(GB41), in the control group. Every group was treated three times a week for two weeks. A follow-up was performed at one month after the completion of treatment. Headache was scored using the VAS, and continuous headache time, headache frequency and range of motion (ROM) of cervical spine were scored before treatment, at the end ofone week’s treatment, at the completion of treatment and at one month after the completion of treatment. The therapeutic effect at the completion of treatment and the follow-up was evaluated according to criteria for assessing the therapeutic effect.ResultAt the completion of treatment and the follow-up, the headache score and the range of motion of cervical spine score were lower in the treatment group than in the control group (P<0.05). In the treatment group, the total efficacy rate was 91.1% at the completion of treatment and 86.7% at the follow-up; the short-term and the long-term therapeutic effects were superior to those in the control group (P<0.05). After one week of treatment, the total efficacy rate was 57.8%, which was higher than 11.4% in thecontrol group (P<0.05).ConclusionTreatment with nape eight needles plus cephalic ashi point needle retention has a marked improving effect on headache symptoms and range of motion of cervical spine in cervicogenic headache. Its short-term and long-termtherapeutic effects are superior to those of conventional acupuncture. It has a higher efficacy rate and effect-producing speed.
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ObjectiveTo objectively evaluate the clinical efficacy of three-step acupuncture-cupping therapy for cervicogenic headache.MethodSixty patients were randomly allocated to treatment and control groups. The treatment group received three-step acupuncture-cupping therapy and the control group, conventional acupuncture based on “Acupuncture Therapeutics”. Both groups were treated for three courses (10 days as acourse with two days of rest between two courses) and then the clinical therapeutic effects were evaluated. The evaluation included the overall therapeutic effect on the symptoms, the VASscore and the follow-up recurrence rate at six months after treatment.ResultThe total efficacy rate was 96.7% in the treatment group and 83.3% in the control group; there was a statistically significant difference between the two groups (P<0.01). A follow-up of six months after treatment in the two groups showed that the recurrence rate was 16.7% in the treatment group and 46.7% in the control group;there was a statistically significant difference between the two groups (P<0.05).ConclusionThree-step acupuncture-cupping therapy has a definite effect on cervicogenic headache. Its immediate and long-term effects are superior to those of conventional acupuncture. The recurrence rate in six months is lower in this therapy than in conventionalacupuncture.
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No abstract available.
Subject(s)
Arthritis, Rheumatoid , Headache , Post-Traumatic HeadacheABSTRACT
Cervicogenic headache is pain from the head due to various sources in the cervical spine. The C2-3 zygapophysial joints are the most commonly involved structure, and this type of headache could be relieved by blocks or neurotomy of the third occipital nerve. A 59-years-old female patient suffered from cervicogenic headaches due to severe C2-3 zygapophysial joint hypertrophy. Her pain was partially relieved by the third occipital radiofrequency neurotomy, and was almost completely removed by C3 deep medial branch neurotomy. Herein, we report a case of osteoarthritis associated cervicogenic headaches at the C2-3 zygapophysial joints and proposed a treatment option.
Subject(s)
Female , Humans , Head , Headache , Hypertrophy , Joints , Osteoarthritis , Post-Traumatic Headache , Spine , Zygapophyseal JointABSTRACT
BACKGROUND AND PURPOSE: Chronic tension-type headache (a primary headache disorder) and cervicogenic headache (a secondary headache disorder that is attributable to upper cervical spine pathology) share similar clinical manifestations, but their associated personality traits may differ. We evaluated the personality differences between sufferers of chronic tension-type headache and cervicogenic headache. METHODS: We administered the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) and the Zuckerman Sensation-Seeking Scale (SSS) to 18 patients suffering from chronic tension-type headache, 19 suffering from cervicogenic headache, and 26 healthy volunteers. Depressive trends were measured with the Plutchik-van-Praag Depression Inventory (PVP). RESULTS: Compared to healthy controls, the chronic tension-type headache group scored significantly higher on ZKPQ Neuroticism-Anxiety and on the PVP, while the cervicogenic headache group scored significantly lower on SSS Thrill and Adventure Seeking. In addition, the total SSS score was significantly lower in the cervicogenic headache group than in both the chronic tension-type headache group and the healthy controls. CONCLUSIONS: The results of this study indicate that higher scores for neuroticism-anxiety and depression were associated with chronic tension-type headache, while lower sensation-seeking scores were associated with cervicogenic headache.
Subject(s)
Humans , Male , Depression , Headache , Headache Disorders, Secondary , Post-Traumatic Headache , Spine , Stress, Psychological , Tension-Type Headache , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Cervicogenic headache (CGH) is known to be mainly related with upper cervical problems. In this study, the effect of radiofrequency neurotomy (RFN) for lower cervical (C4-7) medial branches on CGH was evaluated. METHODS: Eleven patients with neck pain and headache, who were treated with lower cervical RFN due to supposed lower cervical zygapophysial joint pain without symptomatic intervertebral disc problem or stenosis, were enrolled in this study. CGH was diagnosed according to the diagnostic criteria of the cervicogenic headache international study group. Visual analogue scale (VAS) score and degree of VAS improvement (VASi) (%) were checked for evaluation of the effect of lower cervical RFN on CGH. RESULTS: The VAS score at 6 months after RFN was 2.7+/-1.3, which were significantly decreased comparing to the VAS score before RFN, 8.1+/-1.1 (p<0.001). The VASi at 6 months after RFN was 63.8+/-17.1%. There was no serious complication. CONCLUSION: Our data suggest that lower cervical disorders can play a role in the genesis of headache in addition to the upper cervical disorders or independently.
Subject(s)
Humans , Arthralgia , Constriction, Pathologic , Headache , Intervertebral Disc , Neck Pain , Post-Traumatic HeadacheABSTRACT
The differential diagnosis of headache is often difficult because the symptom of headache is overlapping. Superficial cervical plexus block is useful in diagnosis and treatment of headache. Headache arising from the neck and radiating to the frontotemporal regions and possibly to the supraorbital region has been defined as cervicogenic headache. A positive response to anesthetic blocks is one of the diagnostic criteria of cervicogenic headache. We experienced a case of headache arising from direct lymph node metastasis of hepatocellular carcinoma adjacent to the superficial cervical plexus during treatment of cervicogenic headache under ultrasonographic guidance. Especially in patients with medical history of cancer, practitioners should consider the possibility of metastasis to cervical lymph nodes and using ultrasonography to evaluate the cervical area prior to the practice.
Subject(s)
Humans , Carcinoma, Hepatocellular , Cervical Plexus , Diagnosis, Differential , Headache , Lymph Nodes , Neck , Neoplasm Metastasis , Post-Traumatic HeadacheABSTRACT
@# Objective To investigate the incidence, possible mechanisms, clinical features of severe headache after posterior fossa craniotomy. Methods 119 neurosurgical patients undergoing selective posterior fossa craniotomy were analyzed retrospectively. Results 45 （37.8%） patients experienced severe postoperative pain, which could be identified as neuralgia (19 cases), cervicogenic headache (9 cases) and incision of scalp pain （17 cases）. Conclusion In addition to neuralgia and incision of scalp pain, cervicogenic factor plays an important role in severe headache after posterior fossa craniotomy.
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Skull base osteomyelitis is a rare but life-threatening complication of inflammation of the ear. The authors present a case of skull base osteomyelitis of unknown etiology in a non-diabetic patient who presented with unilateral posterior neck and occipital headache mimicking cervicogenic headache.
Subject(s)
Humans , Ear , Headache , Inflammation , Neck , Osteomyelitis , Post-Traumatic Headache , Skull , Skull BaseABSTRACT
Pulsed or conventional radiofrequency (RF) denervation of the third occipital nerve (TON) is considered to be a safe and effective alternative for the treatment of pain originating from the cervical 2-3 facet joint, including cervicogenic headache. However, proper positioning of the RF probe in the TON can be difficult and time consuming due to the possible involvement of various lesions along the target nerve. We found that bipolar RF is easier to perform and more convenient than unipolar RF when administering a lumbar medial branch block. Here, we report the successful treatment of a patient with a cervicogenic headache by pulsed RF (PRF) denervation of the TON, using a bipolar probe. We believe that bipolar PRF denervation of the TON is an effective alternative to unipolar RF or PRF for the treatment of pain originating from the cervical 2-3 facet joint.
Subject(s)
Humans , Denervation , Post-Traumatic Headache , Zygapophyseal JointABSTRACT
@#Objective To evaluate the effect of nerve block and nerve block combined with glycerol and fructose injection on cervicogenic headache (CEH).Methods 50 CEH patients were randomly divided into the nerve block group (n=25), received the occipital and C2 nerve block; nerve block combined with glycerol and fructose injection group (n=25), received nerve block plus glycerol and fructose injection. The pain degree (numeric rating scales, NRS) and the degree of cervical stiff measured by restriction of the range of motion of the neck (ROM) were recorded.Results NRS and ROM decreased significantly after treatment compared with the baseline in two groups ( P<0.01). NRS and ROM decreased much more in the nerve block combined with glycerol and fructose injection group than in the nerve block group ( P< 0.01).Conclusion Nerve block combined with glycerol and fructose injection is a more safe and effective method in the treatment of CEH.
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@#Objective To compare the effects of nerve block using diprospan, triamcinolone and lysinipirium on cervicogenic headache (CEH).Methods Sixty CEH patients were randomly divided into three groups (20 cases in each group), treated by occipital nerve block and C2 neural blockade with diprospan, triamcinolone and lysinipirium respectively, combined with a mixture of 0.4% lidocaine. All patients in three groups were evaluated by numeric rating scales (NRS) for pain degree and range of motion of the neck (ROM) before and after the nerve block.Results The scores of NRS decreased significantly and ROM improved in all groups after treatment ( P<0.01). There were no significant differences between diprospan group and triamcinolone group, but these two groups had a better effect than lysinipirium group ( P<0.01).Conclusion Nerve block using diprospan and triamcinolone can obtain a significant effect in the treatment of CEH.
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Cervicogenic headache is a syndrome characterized by chronic hemicranial pain referred to the head from either bony structures or soft tissues of the neck. Although the pathophysiology and source of pain in this condition have been debated, the pain is believed to be referred from one or more muscles, occipital nerves, facet joints, intervertebral discs, or vascular structures. Among the various possible pain sources, cervicogenic headache from discogenic origin (disc herniation or damaged annulus fibrosus) has been called "discogenic cervical headache". We report a case of cervicogenic headache caused by C3-C4 intervertebral disc herniation. A 33-year-old man presented with headache and posterior neck and right shoulder pain. These symptoms did not improve after therapy with medication, trigger point injection, intramuscular stimulation, greater occipital nerve block, third occipital nerve block, or cervical medial branch block. However, after diagnostic cervical epidural block, the patient's symptoms improved dramatically. Diagnostic magnetic resonance imaging findings confirmed C3-C4 intervertebral disc herniation.