Effects of Graston Versus Myofascial Release Technique in Patients With Cervicogenic Headache
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Graston technique, Myofascial Release Therapy.
- Who it may be relevant to
- Registry conditions: Cervicogenic Headache. Basic parameters: 18 years — 40 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Effects of Graston Versus Myofascial Release Technique on Pain, Range of Motion and Functional Disability in Patients With Cervicogenic Headache
Overview
Cervicogenic Headache (CGH) is a painful condition that has pronounced impacts on quality and activity of daily lives. It is often associated with decreased mobility, muscular tightness, and postural deviations. When neck muscles become tight, weak, or irritated, they change the way the neck moves and put pressure on nearby joints and nerves. This pressure delivers pain signals to the head, causing a Cervicogenic headache.
Detailed description
The aim of this study is to compare the effects of the Graston Technique and Myofascial Release in reducing pain, improving cervical range of motion, and decreasing functional disability in patients with Cervicogenic headache.
This study will be a randomized control trial and will be take place at Sehat Medical Complex, lake city branch, Lahore. Non-probability convenience sampling will be used to collect data. Sample size of ( ) subjects with age group between 18-40 years will be taken. Data will be collected from the patients having present complaint of Cervicogenic headache. Outcome measures will be assessed using numeric pain rating scale (NPRS) for pain, Neck Disability Index (NDI) to measure neck related disability, Headache Disability Index (HDI) to assess the impact of headaches on daily activities and emotional well-being and Goniometer for assessing range of motions. An informed consent will be taken and subjects will be selected on basis of inclusion and exclusion criteria. They will be divided into two groups by random number generator. One group will receive Graston technique and other myofascial release as a treatment while both groups will be receiving conventional treatment alongside. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 21.
Interventions
- Other Graston technique
* Applied to: Sternocleidomastoid, Upper trapezius, Levator scapulae, Suboccipitals and cervical paraspinals. * Duration: 5-7 minutes per session, depending on patient tolerance and therapist assessment. * Frequency: 2-3 sessions per week, for 4 weeks - Other Myofascial Release Therapy
* Manual release applied to same regions as above using sustained pressure and fascial stretch. * Duration: 7-10 minutes per session. * Frequency: 2-3 sessions per week, for 4 weeks.
Primary outcome measures
- Neck Disability Index (NDI) [Time frame: upto 4 weeks]
- Numeric Pain Rating Scale (NPRS) [Time frame: upto 4 weeks]
Secondary outcome measures (2)
- Universal Goniometer (UG) [Time frame: upto 4 weeks]
- Global Rating of Change (GROC) scale [Time frame: upto 4 weeks]
Eligibility criteria
Inclusion criteria
- Males and females between age 18-40 years \[A30.1\]of age with Cervicogenic Headache
- Diagnosed with Cervicogenic headache according to ICHD-3 criteria (3)
- Presence of active myofascial trigger points in the SCM and upper trapezius and subocvcipital levator scapuli (confirmed \[A31.1\]via palpation and referred pain) simens \[A32.1\]criteria
- Positive Cervical Flexion Rotation Test
Exclusion criteria
- Any history of cervical trauma, fracture, or recent surgery.
- Diagnosis of migraine, tension-type headache, or cluster headache (9).
- Any cervical spine pathology e.g. cervical myelopathies and arthropathies.
- Pregnant or lactating women.
- Skin conditions or open wounds that contraindicate use of Graston tools e.g. open wounds, skin infections and burns etc.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Center list to be confirmed — check the primary protocol.
Publications
- Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. Lancet Neurol. 2009 Oct;8(10):959-68. doi: 10.1016/S1474-4422(09)70209-1. PMID 19747657
- Hall TM, Briffa K, Hopper D, Robinson K. Comparative analysis and diagnostic accuracy of the cervical flexion-rotation test. J Headache Pain. 2010 Oct;11(5):391-7. doi: 10.1007/s10194-010-0222-3. Epub 2010 May 28. PMID 20508964
- Nambi G, Alghadier M, Pakkir Mohamed SH, Vellaiyan A, Ebrahim EE, Sobeh DE, Kashoo FZ, Albarakati AJA, Alshahrani NA, Eswaramoorthi V. Combined and isolated effects of workstation ergonomics and physiotherapy in improving cervicogenic headache and work ability in office workers: a single-blinded, randomized controlled study. Front Public Health. 2024 Nov 28;12:1438591. doi: 10.3389/fpubh.2024.1438 PMID 39697289
- Lerner-Lentz A, O'Halloran B, Donaldson M, Cleland JA. Pragmatic application of manipulation versus mobilization to the upper segments of the cervical spine plus exercise for treatment of cervicogenic headache: a randomized clinical trial. J Man Manip Ther. 2021 Oct;29(5):267-275. doi: 10.1080/10669817.2020.1834322. Epub 2020 Nov 5. PMID 33148134
- Verma S, Tripathi M, Chandra PS. Cervicogenic Headache: Current Perspectives. Neurol India. 2021 Mar-Apr;69(Supplement):S194-S198. doi: 10.4103/0028-3886.315992. PMID 34003165
- Mingels S, Granitzer M, Jull G, Dankaerts W. The occurrence of cervicogenic headache: A mapping review. Musculoskelet Sci Pract. 2025 Jun;77:103290. doi: 10.1016/j.msksp.2025.103290. Epub 2025 Feb 20. PMID 40031141
- Robinson CL, Christensen RH, Al-Khazali HM, Amin FM, Yang A, Lipton RB, Ashina S. Prevalence and relative frequency of cervicogenic headache in population- and clinic-based studies: A systematic review and meta-analysis. Cephalalgia. 2025 Mar;45(3):3331024251322446. doi: 10.1177/03331024251322446. Epub 2025 Mar 17. PMID 40094720
- Olesen J. International Classification of Headache Disorders. Lancet Neurol. 2018 May;17(5):396-397. doi: 10.1016/S1474-4422(18)30085-1. Epub 2018 Mar 14. No abstract available. PMID 29550365
Identifiers
NCT: NCT07724639 · REC/RCR & AHS/25/0140- sofia