Dry Needling Versus Dry Cupping on Pain and Disability in Cervicogenic Headache Patients

NCT06689371 | Not Yet Recruiting

• 1 other identifier: R.T.REC/012/005277
• Study Type: interventional
• Target: 45
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study aims to compare the added effects of dry needling and dry cupping to conventional physical therapy on headache pain intensity, headache frequency, headache duration, upper cervical range of motion, and disability levels in patients with cervicogenic headache. It will be assumed that:

• All patients will follow all the given instructions strictly during the study duration, regarding the assessment and the treatment procedure.
• All participants will be evaluated under the same environmental conditions.

Conditions

Dry Needling; Dry Cupping; Cervicogenic Headache

Outcome Measures

Primary Outcomes (5)

• Cervical Range of Motion (CROM)

  CROM device will be used for the assessment of upper cervical ROM.

  Pre- intervention and after 4 weeks of treatment

• The Arabic Version Of Neck Disability Index (NDI).

  to assess the level of disabilities in patients with cervicogenic headache, in % points.

  Pre- intervention and after 4 weeks of treatment

• Headache impact test 6 items

  used to assess headache severity.

  Pre- intervention and after 4 weeks of treatment

• Numerical pain rating scale

  used to assess headache pain intenisty.

  Pre- intervention and after 4 weeks of treatment

• Pressure Algometer

  used to assess trigger points pain pressure threshold

  Pre- intervention and after 4 weeks of treatment

Study Arms (3)

Group A (Dry needling): The 15 patients will receive three dry needling sessions per week for four

EXPERIMENTAL

Other: Group A (Dry Needling)

Group B (Dry cupping): The 15 patients will receive three dry cupping sessions per week for four we

EXPERIMENTAL

Other: Group B (Dry cupping)

Group C (control): The 15 patients will receive standard exercise three sessions per week for four w

ACTIVE COMPARATOR

Other: Group C (control)

Interventions

Group A (Dry Needling) OTHER

The patient will receive dry needling on suboccipital, upper trapezius and SCM muscles with conventional therapy 3 sessions per week for 4 weeks.

Group A (Dry needling): The 15 patients will receive three dry needling sessions per week for four

Group B (Dry cupping) OTHER

Patients will receive dry cupping on suboccipital, upper trapezius and SCM muscles weeks with conventional therapy 3 sessions per week for 4 weeks.

Group B (Dry cupping): The 15 patients will receive three dry cupping sessions per week for four we

Group C (control) OTHER

will receive standard exercise three sessions per week for four weeks. This standard regimen consists of the same exercises as group A and B.

Group C (control): The 15 patients will receive standard exercise three sessions per week for four w

Eligibility Criteria

• Age: 25 Years - 45 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• The patients will be included in our study if they meet the following criteria:
• Age between 25-45 years old for both genders.
• No physiotherapy intervention for the last three months.
• Intermittent headaches of varying duration and pain level at the rate of one headache per week for greater than 2 months.
• Ipsilateral neck, shoulder, or arm pain.
• Provocation of usual head pain by neck movement, sustained awkward neck positions or external pressure over the upper cervical or occipital region on the symptomatic side.
• Limited neck ROM \> 10 degrees confirmed by a positive Flexion Rotation Test.
• Active trigger points (TrPs) within the suboccipital, upper trapezius or sternocleidomastoid muscles.
• The diagnosis of active TrPs will be based on the major criteria proposed by):
• Presence of a palpable taut band in a skeletal muscle
• presence of a hypersensitive point in the taut band
• local twitch response elicited by the snapping palpation of the taut band
• reproduction of the referred pain in response to compression
• patient recognition of the referred pain as a familiar symptom

You may not qualify if:

• The patients will be excluded if they have:
• Cervical radiculopathy.
• History of neck, shoulder trauma or surgery.
• Physical therapy intervention in the neck and shoulder region in the previous 3 months.
• Vertebrobasilar insufficiency or vestibular dysfunctions.
• Evidence of cognitive deficits.
• Presence of any needle contraindication.
• Presence of any cupping contraindication.

Sponsors & Collaborators

• Cairo University: lead

Related Publications (44)

• Ahmed SM, Madbouly NH, Maklad SS, Abu-Shady EA. Immunomodulatory effects of blood letting cupping therapy in patients with rheumatoid arthritis. Egypt J Immunol. 2005;12(2):39-51.

  PMID: 17977209 BACKGROUND

• Al-Bedah AMN, Elsubai IS, Qureshi NA, Aboushanab TS, Ali GIM, El-Olemy AT, Khalil AAH, Khalil MKM, Alqaed MS. The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med. 2018 Apr 30;9(2):90-97. doi: 10.1016/j.jtcme.2018.03.003. eCollection 2019 Apr.

  PMID: 30963043 BACKGROUND

• Audette I, Dumas JP, Cote JN, De Serres SJ. Validity and between-day reliability of the cervical range of motion (CROM) device. J Orthop Sports Phys Ther. 2010 May;40(5):318-23. doi: 10.2519/jospt.2010.3180.

  PMID: 20436238 BACKGROUND

• Berger AA, Liu Y, Mosel L, Champagne KA, Ruoff MT, Cornett EM, Kaye AD, Imani F, Shakeri A, Varrassi G, Viswanath O, Urits I. Efficacy of Dry Needling and Acupuncture in the Treatment of Neck Pain. Anesth Pain Med. 2021 Apr 3;11(2):e113627. doi: 10.5812/aapm.113627. eCollection 2021 Apr.

  PMID: 34336626 BACKGROUND

• Bravo Petersen SM, Vardaxis VG. The flexion-rotation test performed actively and passively: a comparison of range of motion in patients with cervicogenic headache. J Man Manip Ther. 2015 May;23(2):61-7. doi: 10.1179/2042618614Y.0000000085.

  PMID: 26109826 BACKGROUND

• Cagnie B, Dewitte V, Barbe T, Timmermans F, Delrue N, Meeus M. Physiologic effects of dry needling. Curr Pain Headache Rep. 2013 Aug;17(8):348. doi: 10.1007/s11916-013-0348-5.

  PMID: 23801002 BACKGROUND

• Cardoso R, Seixas A, Rodrigues S, Moreira-Silva I, Ventura N, Azevedo J, Monsignori F. The effectiveness of Sustained Natural Apophyseal Glide on Flexion Rotation Test, pain intensity, and functionality in subjects with Cervicogenic Headache: A Systematic Review of Randomized Trials. Arch Physiother. 2022 Sep 1;12(1):20. doi: 10.1186/s40945-022-00144-3.

  PMID: 36045409 BACKGROUND

• Chys M, De Meulemeester K, De Greef I, Murillo C, Kindt W, Kouzouz Y, Lescroart B, Cagnie B. Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain-An Umbrella Review. J Clin Med. 2023 Feb 2;12(3):1205. doi: 10.3390/jcm12031205.

  PMID: 36769852 BACKGROUND

• Dunning J, Butts R, Mourad F, Young I, Flannagan S, Perreault T. Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev. 2014 Aug;19(4):252-265. doi: 10.1179/108331913X13844245102034.

  PMID: 25143704 BACKGROUND

• Ekhator C, Urbi A, Nduma BN, Ambe S, Fonkem E. Safety and Efficacy of Radiofrequency Ablation and Epidural Steroid Injection for Management of Cervicogenic Headaches and Neck Pain: Meta-Analysis and Literature Review. Cureus. 2023 Feb 13;15(2):e34932. doi: 10.7759/cureus.34932. eCollection 2023 Feb.

  PMID: 36938280 BACKGROUND

• Fernandez-de-las-Penas C, Cuadrado ML, Arendt-Nielsen L, Simons DG, Pareja JA. Myofascial trigger points and sensitization: an updated pain model for tension-type headache. Cephalalgia. 2007 May;27(5):383-93. doi: 10.1111/j.1468-2982.2007.01295.x. Epub 2007 Mar 14.

  PMID: 17359516 BACKGROUND

• France S, Bown J, Nowosilskyj M, Mott M, Rand S, Walters J. Evidence for the use of dry needling and physiotherapy in the management of cervicogenic or tension-type headache: a systematic review. Cephalalgia. 2014 Oct;34(12):994-1003. doi: 10.1177/0333102414523847. Epub 2014 Mar 12.

  PMID: 24623124 BACKGROUND

• Ge W, Leson C, Vukovic C. Dry cupping for plantar fasciitis: a randomized controlled trial. J Phys Ther Sci. 2017 May;29(5):859-862. doi: 10.1589/jpts.29.859. Epub 2017 May 16.

  PMID: 28603360 BACKGROUND

• Ghods R, Sayfouri N, Ayati MH. Anatomical Features of the Interscapular Area Where Wet Cupping Therapy Is Done and Its Possible Relation to Acupuncture Meridians. J Acupunct Meridian Stud. 2016 Dec;9(6):290-296. doi: 10.1016/j.jams.2016.06.004. Epub 2016 Sep 15.

  PMID: 28010830 BACKGROUND

• Gugliotti M, Tau J, Gallo K, Sagliocca N, Horan M, Sussman N, Wisnewski R. Between-week reliability of the cervical range of motion (CROM) device for upper cervical rotation. J Man Manip Ther. 2021 Jun;29(3):176-180. doi: 10.1080/10669817.2020.1805691. Epub 2020 Aug 18.

  PMID: 32808588 BACKGROUND

• Iglesias-Gonzalez JJ, Munoz-Garcia MT, Rodrigues-de-Souza DP, Alburquerque-Sendin F, Fernandez-de-Las-Penas C. Myofascial trigger points, pain, disability, and sleep quality in patients with chronic nonspecific low back pain. Pain Med. 2013 Dec;14(12):1964-70. doi: 10.1111/pme.12224. Epub 2013 Aug 15.

  PMID: 23947760 BACKGROUND

• Ireland J, Window P, O'Leary SP. The impact of exercise intended for fitness or sport on the prevalence of non-specific neck pain in adults: A systematic review. Musculoskeletal Care. 2022 Jun;20(2):229-244. doi: 10.1002/msc.1592. Epub 2021 Sep 29.

  PMID: 34586706 BACKGROUND

• Jung A, Carvalho GF, Szikszay TM, Pawlowsky V, Gabler T, Luedtke K. Physical Therapist Interventions to Reduce Headache Intensity, Frequency, and Duration in Patients With Cervicogenic Headache: A Systematic Review and Network Meta-Analysis. Phys Ther. 2024 Feb 1;104(2):pzad154. doi: 10.1093/ptj/pzad154.

  PMID: 37941472 BACKGROUND

• Kietrys DM, Palombaro KM, Azzaretto E, Hubler R, Schaller B, Schlussel JM, Tucker M. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013 Sep;43(9):620-34. doi: 10.2519/jospt.2013.4668.

  PMID: 23756457 BACKGROUND

• Kim JI, Lee MS, Lee DH, Boddy K, Ernst E. Cupping for treating pain: a systematic review. Evid Based Complement Alternat Med. 2011;2011:467014. doi: 10.1093/ecam/nep035. Epub 2011 Jun 23.

  PMID: 19423657 BACKGROUND

• Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010 Jun;9(2):49-59. doi: 10.1016/j.jcm.2010.03.002.

  PMID: 21629550 BACKGROUND

• Mohamed AA, Shendy WS, Semary M, Mourad HS, Battecha KH, Soliman ES, Sayed SHE, Mohamed GI. Combined use of cervical headache snag and cervical snag half rotation techniques in the treatment of cervicogenic headache. J Phys Ther Sci. 2019 Apr;31(4):376-381. doi: 10.1589/jpts.31.376. Epub 2019 Apr 1.

  PMID: 31037013 BACKGROUND

• Mousavi-Khatir SR, Fernandez-de-Las-Penas C, Saadat P, Javanshir K, Zohrevand A. The Effect of Adding Dry Needling to Physical Therapy in the Treatment of Cervicogenic Headache: A Randomized Controlled Trial. Pain Med. 2022 Mar 2;23(3):579-589. doi: 10.1093/pm/pnab312.

  PMID: 34687308 BACKGROUND

• Murtza S, Noor R, Bashir MS, Ikram M. Effects of sustained natural apophyseal glides versus rocabado 6 x 6 program in subjects with cervicogenic headache. BMC Musculoskelet Disord. 2024 Feb 22;25(1):169. doi: 10.1186/s12891-024-07290-8.

  PMID: 38389050 BACKGROUND

• Nunez-Cabaleiro P, Leiros-Rodriguez R. Effectiveness of manual therapy in the treatment of cervicogenic headache: A systematic review. Headache. 2022 Mar;62(3):271-283. doi: 10.1111/head.14278. Epub 2022 Mar 16.

  PMID: 35294051 BACKGROUND

• Ogince M, Hall T, Robinson K, Blackmore AM. The diagnostic validity of the cervical flexion-rotation test in C1/2-related cervicogenic headache. Man Ther. 2007 Aug;12(3):256-62. doi: 10.1016/j.math.2006.06.016. Epub 2006 Nov 16.

  PMID: 17112768 BACKGROUND

• Polat B, Saatci O, Yilmaz NH, Duz OA. The frequency of complementary and integrative medicine methods in headache patients and their spending habits. Neurol Neurochir Pol. 2018 May-Jun;52(3):347-351. doi: 10.1016/j.pjnns.2017.12.007. Epub 2017 Dec 24.

  PMID: 29306601 BACKGROUND

• Pourahmadi M, Dommerholt J, Fernandez-de-Las-Penas C, Koes BW, Mohseni-Bandpei MA, Mansournia MA, Delavari S, Keshtkar A, Bahramian M. Dry Needling for the Treatment of Tension-Type, Cervicogenic, or Migraine Headaches: A Systematic Review and Meta-Analysis. Phys Ther. 2021 May 4;101(5):pzab068. doi: 10.1093/ptj/pzab068.

  PMID: 33609358 BACKGROUND

• Racicki S, Gerwin S, Diclaudio S, Reinmann S, Donaldson M. Conservative physical therapy management for the treatment of cervicogenic headache: a systematic review. J Man Manip Ther. 2013 May;21(2):113-24. doi: 10.1179/2042618612Y.0000000025.

  PMID: 24421621 BACKGROUND

• Rendas-Baum R, Yang M, Varon SF, Bloudek LM, DeGryse RE, Kosinski M. Validation of the Headache Impact Test (HIT-6) in patients with chronic migraine. Health Qual Life Outcomes. 2014 Aug 1;12:117. doi: 10.1186/s12955-014-0117-0.

  PMID: 25080874 BACKGROUND

• Satpute K, Nalband S, Hall T. The C0-C2 axial rotation test: normal values, intra- and inter-rater reliability and correlation with the flexion rotation test in normal subjects. J Man Manip Ther. 2019 May;27(2):92-98. doi: 10.1080/10669817.2018.1533195. Epub 2018 Oct 12.

  PMID: 30935342 BACKGROUND

• Sedighi A, Nakhostin Ansari N, Naghdi S. Comparison of acute effects of superficial and deep dry needling into trigger points of suboccipital and upper trapezius muscles in patients with cervicogenic headache. J Bodyw Mov Ther. 2017 Oct;21(4):810-814. doi: 10.1016/j.jbmt.2017.01.002. Epub 2017 Jan 6.

  PMID: 29037632 BACKGROUND

• Shen WC, Jan YK, Liau BY, Lin Q, Wang S, Tai CC, Lung CW. Effectiveness of self-management of dry and wet cupping therapy for low back pain: A systematic review and meta-analysis. Medicine (Baltimore). 2022 Dec 23;101(51):e32325. doi: 10.1097/MD.0000000000032325.

  PMID: 36595746 BACKGROUND

• Shimohata K, Hasegawa K, Onodera O, Nishizawa M, Shimohata T. The Clinical Features, Risk Factors, and Surgical Treatment of Cervicogenic Headache in Patients With Cervical Spine Disorders Requiring Surgery. Headache. 2017 Jul;57(7):1109-1117. doi: 10.1111/head.13123. Epub 2017 Jun 5.

  PMID: 28581034 BACKGROUND

• Silva HJA, Saragiotto BT, Silva RS, Lins CAA, de Souza MC. Dry cupping in the treatment of individuals with non-specific chronic low back pain: a protocol for a placebo-controlled, randomised, double-blind study. BMJ Open. 2019 Dec 22;9(12):e032416. doi: 10.1136/bmjopen-2019-032416.

  PMID: 31871257 BACKGROUND

• Stephens SL, Selkow NM, Hoffman NL. Dry Cupping Therapy for Improving Nonspecific Neck Pain and Subcutaneous Hemodynamics. J Athl Train. 2020 Jul 1;55(7):682-690. doi: 10.4085/1062-6050-236-19.

  PMID: 32556324 BACKGROUND

• Mohammadi Z, Shafizadegan Z, Tarrahi MJ, Taheri N. The Effectiveness of Sternocleidomastoid Muscle Dry Needling in Patients with Cervicogenic Headache. Adv Biomed Res. 2021 Feb 26;10:10. doi: 10.4103/abr.abr_138_20. eCollection 2021.

  PMID: 33959567 BACKGROUND

• Tekin L, Akarsu S, Durmus O, Cakar E, Dincer U, Kiralp MZ. The effect of dry needling in the treatment of myofascial pain syndrome: a randomized double-blinded placebo-controlled trial. Clin Rheumatol. 2013 Mar;32(3):309-15. doi: 10.1007/s10067-012-2112-3. Epub 2012 Nov 9.

  PMID: 23138883 BACKGROUND

• Wood S, Fryer G, Tan LLF, Cleary C. Dry cupping for musculoskeletal pain and range of motion: A systematic review and meta-analysis. J Bodyw Mov Ther. 2020 Oct;24(4):503-518. doi: 10.1016/j.jbmt.2020.06.024. Epub 2020 Jul 30.

  PMID: 33218554 BACKGROUND

• Yanase K, Ikezoe T, Nakamura M, Saeki J, Yagi M, Hirono T, Tamezawa T, Motomura Y, Ibuki S, Ichihashi N. Effective muscle elongation positions for the neck extensor muscles: An ultrasonic shear wave elastography study. J Electromyogr Kinesiol. 2021 Oct;60:102569. doi: 10.1016/j.jelekin.2021.102569. Epub 2021 Jun 17.

  PMID: 34298283 BACKGROUND

• Yeganeh Lari A, Okhovatian F, Naimi Ss, Baghban AA. The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females. Man Ther. 2016 Feb;21:204-9. doi: 10.1016/j.math.2015.08.004. Epub 2015 Aug 14.

  PMID: 26304789 BACKGROUND

• Yehoshua I, Rimon O, Mizrahi Reuveni M, Peleg R, Adler L. Dry needling for the treatment of acute myofascial pain syndrome in general practitioners' clinics: a cohort study. BMC Prim Care. 2022 Dec 27;23(1):339. doi: 10.1186/s12875-022-01951-0.

  PMID: 36572860 BACKGROUND

• Young IA PT, DSc, Dunning J PT, DPT, Butts R PT, PhD, Mourad F PT, DPT, Cleland JA PT, PhD. Reliability, construct validity, and responsiveness of the neck disability index and numeric pain rating scale in patients with mechanical neck pain without upper extremity symptoms. Physiother Theory Pract. 2019 Dec;35(12):1328-1335. doi: 10.1080/09593985.2018.1471763. Epub 2018 Jun 1.

  PMID: 29856244 BACKGROUND

• Ziaeifar M, Arab AM, Karimi N, Nourbakhsh MR. The effect of dry needling on pain, pressure pain threshold and disability in patients with a myofascial trigger point in the upper trapezius muscle. J Bodyw Mov Ther. 2014 Apr;18(2):298-305. doi: 10.1016/j.jbmt.2013.11.004. Epub 2013 Nov 9.

  PMID: 24725800 BACKGROUND

MeSH Terms

Conditions

Post-Traumatic Headache

Interventions

Dry Needling

Condition Hierarchy (Ancestors)

Headache Disorders, Secondary; Headache Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Intervention Hierarchy (Ancestors)

Complementary Therapies; Therapeutics; Physical Therapy Modalities

Central Study Contacts

Mariam samara Shahen, Demonstrator

CONTACT

+201024909968; msamara@horus.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Demonstrater

Study Record Dates

• First Submitted: November 13, 2024
• First Posted: November 14, 2024
• Study Start: November 13, 2024
• Primary Completion: January 1, 2025
• Study Completion: February 1, 2025
• Last Updated: November 14, 2024

Record last verified: 2024-11