Comparison of effect of dry needling, physiotherapy, and sham dry needling in cervicogenic headache- A randomized controlled clinical trial

Comparison of effect of dry needling, physiotherapy, and sham dry needling in cervicogenic headache

A triple blind randomized clinical trial consisting of three routine physiotherapy groups and a routine physiotherapy with dry needles and a routine physiotherapy with a placebo needle.

Patients in the routine physical therapy group for fifteen sessions, three times a week, will undergo physiotherapy including electrical stimulation, surface heat, neck ultrasound and neck stabilization exercises. In dry needle group, in addition to the above items, dry needle will be performed according to the Dommerholt method for 4 sessions and the second, fifth, eighth and twelfth sessions will be performed at the active trigger points of the upper trapezius muscles, cervical erector spine muscles and sternocleidomastoid. In the placebo group, the needle is very superficial and at a point away from active trigger points during 4 sessions in the muscles, so that we can differentiate the effects of placebo needle dry from its actual effects.The assessments will be done before the treatment immediately after treatment, one month later, three and six months later.

Unilateral headache Starting in the neck Pain aggravated by neck movement Restricted cervical range of motion Joint tenderness in the joints of the upper cervical spine Active trigger point in neck muscles

The cervicogenic headache are randomly divided into three groups. The first group routine physiotherapy, the second group routine physiotherapy and dry needle, the third group routine physiotherapy and placebo needle

The severity and frequency of headaches, Neck range of motion, pressure Pain threshold and tenderness at the trigger point of the muscles, Function of deep neck flexor muscles, neck proprioception

At first, a physiotherapist with ten years of experience perform patient’s physical examination. If they meet the conditions for entry into the study, and don’t have exclusion criteria, a randomization into three groups (control and DN group, sham DN group) was performed by packed envelopes via blind independent researcher to aim of allocation concealment.

In sham dry needling group, the patient will not be aware of the fact that he/she does not receive the actual dry needling. The assessor and therapist will two different individuals and assessor blind to intervention. Also , statistical analysis will be done by a person who is blind to grouping