Effect of Cervical Mobilization, Transcutaneous Electrical Stimulation and Suboccipital Release in Cervicogenic Headache: A Case Report

Abstract

Background: Cervicogenic headaches are one of the common musculoskeletal disorders that originates in the neck and are radiates from neck to head. Cervicogenic headache is usually treated with a comprehensive strategy that includes pharmacologic, nonpharmacologic, manipulative, anesthetic, surgical procedures and physiotherapy. Physiotherapy includes spinal manipulation, mobilization, myofascial release, exercises and electrotherapeutic modalities. Purpose: This case report aims to evaluate the effects of combination of cervical spine mobilization, TENS, Suboccipital release on cervicogenic headache in maintaining long-term benefits. Methods: This a case report of 31-year-old male having cervicogenic headache from 4-5 years. He reported symptoms like pain in right side neck which radiates into head till forehead and stiffness in neck. Physiotherapy treatment like cervical spine mobilization, TENS and Suboccipital release was given for 5 sessions (alternate days) for 10 days. Outcome Measures: Numerical pain rating scale, Neck disability Index and Cervical range of motion was used as outcome measures. Results: There was marked decrease in pain intensity from 8 on NPRS to 1 on NPRS. Also there was increase in cervical range of motion specially flexion, lateral flexion and rotation and decrease in neck disability index from 28 to 10. Conclusion: Physical therapy with TENS, Cervical spine mobilization & sub occipital release can be used as an effective intervention protocol for reducing pain and stiffness and increasing range of motion in patients with Cervicogenic Headache. Key words: Transcutaneous electrical nerve stimulation, Cervical Spine mobilization, Suboccipital release, Cervicogenic Headache, Numerical Pain Rating Scale, Neck Disability Index.