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Non-pharmacological approaches like exercise and
manual therapy may help in the effective management of persistent headaches
related to pain.
According
to a recent study published in 'European Journal of Pain', the evidence‐based
guideline provides recommendations for the conservative management of
persistent headaches concerned with neck pain.
The Guideline Expert Panel fabricated an evidence‐based guideline for
non‐pharmacological management of persistent headaches related to neck pain
(i.e., tension‐type or cervicogenic).
The systematic reviews of high‐quality studies were the basis of this
guideline. The cost-effectiveness, clinical advantages, societal and ethical
values, and patient experiences were all considered when formulating the
recommendations by a multidisciplinary expert panel. The target audience
involved clinicians and target population was the adults with persistent
headaches concerned with neck pain.
For efficient management of patients with
headaches relating to neck pain, the clinicians should:
a. Figure out the main structural or other pathologies, or migraine as the
cause of headaches;
b. Sort the headaches concerned with neck pain as tension‐type headache or
cervicogenic headache after the other sources of headache pathology has been
figured out;
c. Provide care in association with the patient and involve the patient in care
planning and decision making;
d. Provide care along with structured patient education;
e. Opt for low‐load endurance craniocervical and cervicoscapular exercises for
management of tension‐type headaches (episodic or chronic) or cervicogenic
headaches >3 months duration;
f. General exercise, multimodal care (spinal mobilization, craniocervical
exercise and postural correction) or clinical massage can be considered for
chronic tension‐type headaches;
g. Manipulation of cervical spine should not be regarded as the only form for
episodic or chronic tension‐type headaches treatment;
h. Opt for manual therapy (manipulation with or without mobilization) to the
cervical and thoracic spine for cervicogenic headaches >3 months duration
i. Reassess the patient at every visit to examine outcomes and determine whether
a referral is indicated.
Pierre Côté et al. concluded, "The affect of the guideline in clinical practice requires validation."
European Journal of Pain
Non‐pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration
Pierre Côté et al.
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