SCM Muscle Released in Patients with Cervicogenic Headache

The Effectiveness of Sternocleidomastoid Muscle Pressure Points in Patients with Cervicogenic Headache

Sternocleidomastoid syndrome is often characterized by referred pain in other areas. Like all muscles, the SCM can develop tight, and non-contracting bands called trigger points that can refer pain elsewhere. For the SCM, the trigger point referral areas are the eye and forehead, the back of the head (occiput), front of the neck, cheek, and side of the head. Trigger points can be treated by direct manual massage, dry needling, or platelet-poor plasma injection.

Study Overview

• Status: Completed
• Conditions: Cervicogenic Headache
• Intervention / Treatment: Other: trigger point pressure; Other: neck exercises

Detailed Description

Cervicogenic headache is a specific type of headache that originates from the cervical spine and is typically chronic in nature. Diagnostic criteria for CGH have been established by the International Headache Society (IHS) and are cited extensively in the literature. Diagnosis of CGH through manual examination is a more recent practice. To our knowledge, no systematic review of manual diagnosis of CGH has been performed.

• Study Type: Interventional
• Enrollment (Actual): 52
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Saudi Arabia
  • Makka, Saudi Arabia
    • Umm Al Qura University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• History of CGH ≥ 3 months at Baseline 1, ≥5 days of CGH per month
• CGH intensity ≥3 (0-10 scale)
• Cervical spine dysfunction (cervical joint tenderness and/or restricted segmental motion)
• Clear temporal sequence linking the source of CGH to the neck: headache preceded by neck pain, stiffness, movement and/or awkward postures

Exclusion Criteria:

• Other headaches within one year of enrollment (e.g. migraine occurring on >1 day per month in the last year, medication overuse, daily, cluster, temporomandibular joint dysfunction related headaches, sinus, posttraumatic, tumor and glaucoma related, occipital neuralgia, metabolic/toxic/substance abuse related).
• Spinal manipulative therapy, massage or exercise therapy for neck pain or headaches in the previous 3 months. Any other types of care by a licensed provider in the previous month for headaches or neck pain
• Contraindications to study treatments (e.g., inflammatory arthropathies, cervical instability, severe osteoporosis, vertigo, dizziness)
• Daily prescription or nonprescription pain medication; corticosteroid use in previous month
• Cancer in the past five years
• ear problem

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: control group	Other: neck exercises; Manual Cervical Traction Technique and others
Experimental: study group	Other: trigger point pressure; The midpoint of the sternocleidomastoid muscle with abundant nerve distribution and the onset and endpoint of the sternocleidomastoid muscle were used as acupoints, which can relieve localised muscle spasms and promote nerve nutrition.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
cervical neck pain	visual analogue scale: This pain scale is most commonly used. A person rates their pain on a scale of 0 to 10 or 0 to 5. Zero means "no pain," and 5 or 10 means "the worst possible pain." These pain intensity levels may be assessed upon initial treatment, or periodically after treatment.	4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
biodex balance system	assessment of posture stability, level eight was selected on the (the most stable level), then the dynamic limit of stability testing mode was selected and then the data of each patient were inserted into the device. The patient was instructed to try to achieve a centered position on the platform by moving their feet, once the platform was programmed to move. Visual feedback was provided on screen, with the cursor moving in relation to the feedback from the patients' feet. Once the cursor had been centered, the platform was kept level beneath the patient's feet while the patient was standing in a comfortable upright position	4 weeks
neck stability index	It is patient-completed, condition-specific functional status questionnaire with 10 items including pain, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation, each item scored with a possible 0-5 value with the larger number indicating a higher self-reported disability status. The score on this questionnaire can range from 0-50. In order to calculate a percentage, simply multiply the final value by two	4 weeks

Collaborators and Investigators

• Sponsor: Al-Zaytoonah University of Jordan

Publications and helpful links

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2025
• Primary Completion (Actual): February 10, 2025
• Study Completion (Actual): February 10, 2025

Study Registration Dates

• First Submitted: December 5, 2024
• First Submitted That Met QC Criteria: December 10, 2024
• First Posted (Actual): December 13, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 10, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: trigger points; headaches; sternocleidomastoid
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Headache Disorders; Headache Disorders, Secondary; Headache; Post-Traumatic Headache
• Other Study ID Numbers: Cervicogenic Headache

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No