Cervicogenic headaches, or headaches referred from the neck, occur in about 2.5% of adults. While most people treat their headaches with medication, research is showing that exercise may be a better long-term solution, particularly for chronic neck pain. Researcher Jari Ylinen MD, PhD from Central Hospital in Finland and his colleagues investigated the effects of Thera-Band® strengthening exercises and endurance exercises in patients with headaches and arm pain associated with neck pain. His findings were published in the Journal of Rehabilitation Medicine.
Previously, Dr. Ylinen published landmark studies showing Thera-Band cervical exercises “relieve or even completely eliminate pain and restore function in patients with chronic neck pain.” His most recent study investigated the same program in patients with neck pain and headaches. In the blinded, randomized controlled trial, 180 female office workers with head and neck pain were assigned to a strengthening group, endurance training, or control group.
Training methods. Both training groups started with 2 weeks of clinical rehabilitation and a home exercise program, 5 days per week. The endurance group exercised by lifting their head up from supine for 3 sets of 20, while the strengthening group used a dynamic isometric Thera-Band exercise in a sitting position for 1 set of 15 in 4 directions.
Both training groups also performed dumbbell exercises including the shrug, press, curl, bent over row, fly, and pull over. The endurance group performed these exercises for 3 sets of 20 using a 2 kg dumbbell, while the strength group performed these exercises for 1 set of 15 at a 15RM resistance using dumbbells. Both groups also performed squat, sit-up, and back extension resistance exercises, as well as stretches for the upper back, shoulder, and neck. The control group performed aerobic exercise 3 times per week for 30 minutes, and received written information on stretches to be performed at home for 20 minutes.
Results. At a 12 month follow-up, the strengthening group utilizing Thera-Band resistance decreased their pain levels by 58-69%. The table below summarizes the percent decrease in headache pain, upper extremity pain, and neck pain in each group compared to their baseline measurement.
|Headache pain||Upper Extremity pain||Neck pain|
The authors noted that patients with the most severe headaches had the most improvement in their neck pain after strength training including Thera-Band resistance. Their findings were similar to Jull and colleagues who found manipulative therapy combined with neck exercise was effective at reducing headaches.
In conclusion, Dr. Ylinen and his colleagues stated that stretching alone is not effective. They suggested that strength or endurance exercise combined with stretching exercise is effective at reducing headache and arm pain associated with neck pain. In addition, patients should continue exercising for at least a year, which may prevent recurrence of pain up to 3 years.
Ylinen et al. 2010. Effect of neck exercises on cervicogenic headache: a randomized controlled trial. J Rehabil Med. 42:344-49.
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