Journal CME, May 2023: Efficacy of physiotherapy interventions for the management of adults with cervicogenic headache: A systematic review and meta-analyses-Journal CME, May 2023: Efficacy of physiotherapy interventions for the management of adults with cervicogenic headache: A systematic review and meta-analyses

Journal CME, May 2023: Efficacy of physiotherapy interventions for the management of adults with cervicogenic headache: A systematic review and meta-analyses

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The systematic review and meta-analyses assessed the efficacy of physiotherapy interventions, specifically manual therapy and exercise therapy, in managing cervicogenic headaches (CGH) in adults. The review included 14 randomized controlled trials (RCTs) up to October 2021 and utilized databases like CINAHL, PEDro, PubMed, Sage Journals, and Wiley Online Library. The trials included interventions such as manual therapy techniques (e.g., joint mobilization and manipulation, trigger point therapy) and exercise therapy, comparing them against sham treatments or no treatment.<br /><br />Key Findings:<br />- **Manual Therapy**: Moderate-certainty evidence suggests manual therapy significantly reduces headache frequency in the short term compared to sham therapy and both frequency and intensity compared to no treatment. However, its long-term effects on headache intensity and frequency were not significant when compared to sham treatments.<br />- **Exercise Therapy**: Long-term neck exercises significantly reduced headache intensity when compared to no treatment or aerobic exercises.<br />- **Combination Therapies**: Combining manual therapy and exercise therapy showed potential benefits, particularly in reducing pain and disability, although these findings need more high-quality evidence for confirmation.<br />- **Overall Quality**: The evidence quality ranged from very low to moderate, primarily downgraded due to risks of bias, inconsistency, and small sample sizes.<br /><br />Conclusions:<br />Manual therapy and specific neck exercises show promise in the short-term management of CGH, but their long-term efficacy is uncertain. There is a need for further high-quality research comparing these physiotherapy interventions to usual medical care, including pharmacological treatments, to establish more generalizable and clinically applicable conclusions.<br /><br />The study emphasizes that while physiotherapy interventions are beneficial, their comparative efficacy and cost-effectiveness against standard treatments remain unclear. Future trials should address these gaps and include larger sample sizes with long-term follow-ups to draw more definitive conclusions.

Keywords

physiotherapy

manual therapy

exercise therapy

cervicogenic headaches

randomized controlled trials

headache management

neck exercises

pain reduction

evidence quality

future research