Effect of neck exercises on cervicogenic headache: a randomized controlled trial

Area of Science:

• Physical Therapy
• Musculoskeletal Disorders
• Pain Management

Background:

• Chronic neck pain is prevalent among office workers, often accompanied by headaches and upper extremity pain.
• Current treatment recommendations for neck pain frequently include stretching exercises.

Purpose of the Study:

• To compare the effectiveness of three distinct 12-month training programs on headache and upper extremity pain in individuals with chronic neck pain.
• To evaluate the impact of different exercise modalities (strength, endurance, and stretching) on pain reduction.

Main Methods:

• 180 female office workers with chronic neck pain were randomized into three groups: strength, endurance, and control (stretching only).
• The strength group performed isometric, dynamic, and stretching exercises; the endurance group performed dynamic muscle and stretching exercises.
• Pain was measured using a visual analogue scale (VAS), with subgroups based on headache intensity.

Main Results:

• After 12 months, headache intensity decreased by 69% in the strength group, 58% in the endurance group, and 37% in the control group.
• The strength training group showed the most significant reduction in neck pain, particularly in those with severe headaches (p < 0.001).
• Upper extremity pain decreased by 58% (strength), 70% (endurance), and 21% (control).

Conclusions:

• While all training programs reduced headache, combining strength and endurance exercises was more effective than stretching alone.
• Stretching alone was less effective for managing headache and upper extremity pain associated with chronic neck pain.
• Clinical recommendations for training modalities should consider patient-specific factors, especially for severe cervicogenic headaches.