Effectiveness of manual therapy for chronic tension-type headache

Chronic tension-type headache has a considerable impact on daily functioning and work participation, it is also a risk factor for overuse of analgesic medication. Only about 20% of the chronic tension-type headache patients seek medical care for their headache. This low consultation rate may be explained by insufficient information on the effectiveness of treatments or by previous negative health care experiences.

The pathogenesis of chronic tension-type headache remains unclear, however, in recent research a correlation between chronic tension-type headache and impairment of the cranio-cervical musculoskeletal function (forward head position, trigger points trapezius muscle, neck mobility) has been demonstrated. In combination with results obtained in previous studies the present data support the hypothesis that improvement of the cranio-cervical musculoskeletal function by a manual therapy intervention (postural correction, mobilization of cervical spine, and training of cervical muscles) may be an important factor to modify central or peripheral pain mechanism in chronic tension-type headache.

The purpose of this study in Cephalgia was to evaluate the effectiveness of manual therapy in participants with chronic tension-type headache, the authors of this study conducted a multicenter, pragmatic, randomised, clinical trial with partly blinded outcome assessment. Eighty-two participants with chronic tension-type headache were randomly assigned to manual therapy or to usual care by the general practitioner. Primary outcome measures were frequency of headache and use of medication. Secondary outcome measures were severity of headache, disability and cervical function.

After 8 weeks (n = 80) and 26 weeks (n = 75), a significantly larger reduction of headache frequency was found for the manual therapy group. Disability and cervical function showed significant differences in favour of the manual therapy group at 8 weeks but were not significantly different at 26 weeks. Manual therapy is more effective than usual general practitioner care in the short and longer term in reducing symptoms of chronic tension-type headache.

Reference: Castien RF, van der Windt DA, Grooten A, Dekker J. Effectiveness of manual therapy for chronic tension-type headache: A pragmatic, randomised, clinical trial. Cephalalgia. 2010 Jul 20.

Dr. David P. Chen
Chiropractor in Laurel, MD 20708
Laurel Regional Chiropractic

Ginger may reduce pain associated with muscle injury after exercising

For centuries, ginger root has been used as a folk remedy for a variety of ailments such as colds and upset stomachs. But now, researchers at the University of Georgia have found that daily ginger consumption also reduces muscle pain caused by exercise. Muscle pain generally is one of the most common types of pain and eccentric exercise-induced muscle pain specifically is a common type of injury related to sports and/or recreational activities.

While ginger had been shown to exert anti-inflammatory effects in rodents, its effect on experimentally-induced human muscle pain was largely unexplored. It was also believed that heating ginger, as occurs with cooking, might increase its pain-relieving effects. Two studies are directed to examine the effects of 11 days of raw and heat-treated ginger supplementation on muscle pain. The researchers recruited 74 volunteers, 34 and 40 respectively, randomly assigned them to consume capsules containing two grams of either raw or heat-treated ginger or a placebo for 11 consecutive days. On the eighth day they performed 18 extensions of the elbow flexors with a heavy weight to induce moderate muscle injury to the arm. Arm function, inflammation, pain and a biochemical involved in pain were assessed prior to and for three days after exercise.

Results showed that supplementation with both raw and heat-treated ginger attenuated muscle pain intensity 24 hours after eccentric exercise. Exercise-induced pain was reduced by 25 percent after daily supplements of raw ginger, and by 23 percent after supplementation with the heat-treated form. The study suggests that ginger may have anti-inflammatory and analgesic properties similar to that of Non-Steroidal Anti-Inflammatory drugs (NSAID’s).

Reference: Black CD, Herring MP, Hurley DJ, O'Connor PJ. Ginger (Zingiber officinale) Reduces Muscle Pain Caused by Eccentric Exercise. J Pain. 2010 Apr 23; DOI: 10.1016/j.jpain.2009.12.013

Dr. David P. Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic