Cervicogenic HeadacheNCT06875869
Ischemic Compression Technique Versus Jones Technique in Cervicogenic Headache Patients
A study testing Jones technique and Ischemic compression therapy in people with Cervicogenic Headache, run by Riphah International University at 1 site in Pakistan.
Trial summary
The primary objective of the study is to determine the effects of Jones and Ischemic compression technique on pain, range of motion and disability in patients with cervicogenic headache. Read more about this study
- Who is it for?
- Ages 25 to 35 years
- Conditions the study is for
- Cervicogenic Headache
- What is being tested?
- Jones technique and Ischemic compression therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 32 participants
- Where
- 1 sitePakistan
- Study dates
- 2 Jan 2025to 15 Sep 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 25 to 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Both males and females
- 25-35 years of age
- Individuals satisfying the Cervicogenic Headache criteria
- Positive Simon's criteria for trigger points
Who cannot join
- primary headaches (i.e., migraine, tension type headache)
- bilateral headache
- Presence of any red flags
- cervical spinal stenosis
- evidence of central nervous system involvement
- prior surgery to the head or neck
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Bahaval Victoria Hospital
Bahawalpur, Punjab Province
Ghulam Fatima, PhD*, 03034073057, ghulam.fatima@riphah.edu.pk
Fatima Ashraf, MS*
About this study
Official title: Comparative Effects of Jones and Ischemic Compression Technique on Pain, Range of Motion and Disability in Patients With Cervicogenic Headache
The primary objective of the study is to determine the effects of Jones and Ischemic compression technique on pain, range of motion and disability in patients with cervicogenic headache. Cervicogenic headache is a distinctive type of secondary headache where the pain originates from structures in the neck or cervical spine and radiates to the head. Trigger point release has been associated with decrease in symptoms of patients with cervicogenic headache. This study will be a randomized clinical trial with the sample size of 32 patients. Participants will be randomly allocated into two groups: Group A and Group B. The setting of the study will be Bahawal Victoria Hospital, Bahawalpur. Group A will receive Jones technique of trigger points of the upper trapezius and sternocleidomastoid muscle while Group B will receive ischemic compression of the trigger points of the upper trapezius and sternocleidomastoid muscle. Patients of both groups will receive two treatment sessions per week for 6 weeks. Both groups will receive hot pack for 10 minutes, TENS for 15 minutes and strengthening exercises for deep neck flexors (chin tuck and head raise with ten repetitions of 10-second duration, with a 10-second rest interval between each contraction) as baseline treatment protocol. NPRS, HDI and FRT will be used as outcome measure tools. Data will be analyzed using SPSS version 25.0 with the p-value of <0.05 taken as significant difference.
Read the detailed description
Cervicogenic headache (CGH) is a secondary headache caused by a disorder of the cervical spine and its disc or bony and/or periarticular components and is often accompanied by neck pain The prevalence cervicogenic headache of in the general population has been reported to be 2.2%-4.1% and appears to predominate in women four times more than in men. Noninvasive treatment techniques consist mainly of electrotherapy, manual therapy (MT), and exercise prescription. Myofascial Trigger Point (MTrP) activity is one of the leading causes of CGH. Jones technique and Ischemic compression ( IC) are two treatment options for trigger points. Cervicogenic headaches are a growing problem impacting daily life, research on cervicogenic headaches is crucial to understand the link between neck issues and headaches, and develop more effective long-term treatment options. In view of the above, the current study aims to evaluate the effectiveness of Physiotherapy interventions i.e. Jones and Ischemic compression technique for Myofascial Trigger Points (MTrPs) of Sternocleidomastoid and upper Trapezius in treating cervicogenic headache.
The current study will help us in determining whether use of these techniques has any significant advantage over conventional treatment for pan and disability in CGH patients. Understanding the most effective therapeutic approach can guide practitioners in selecting evidence-based interventions, ultimately improving the overall well-being of patients suffering from cervicogenic headache.
- Conditions
- Cervicogenic Headache
- Being tested
- Jones technique, Ischemic compression therapy
- Keywords
- Cervicogenic headache, Disability evaluation, Ischemic compression therapy, Pain assessment, Range of motion, Trigger point
- Medical subject headings
- Post-Traumatic Headache
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Jones techniqueOther
In the Jones technique, pressure will be applied on the tender point and the patient's head will be flexed laterally to the side of the tender point, followed by a shoulder abduction of approximately 90 degrees. This position will be held for 90 s and then patient position will be passively returned to the initial position. This will be repeated three times in each session. Patients will receive two treatment sessions per week for 6 weeks
Ischemic compression therapyOther
Patients will receive ischemic compression of the trigger points of the upper trapezius and sternocleidomastoid muscle with hold time varying between 30 seconds to 1 minute repeated 3 to 5 times in each session. Patients will receive two treatment sessions per week for 6 weeks
| Study group | Role | What they receive |
|---|---|---|
| Group-A (Jones technique) | Experimental | Patients will receive Jones technique for the Sternocleidomastoid and upper fibers of Trapezius. Receives: Other: Jones technique |
| Group-B (Ischemic compression therapy) | Active comparator | Patients will receive Ischemic compression for the Sternocleidomastoid and upper fibers of Trapezius Receives: Other: Ischemic compression therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale (NPRS)
It is a standardized self-reporting scale consisting of a horizontal line used to estimate the subjective level of pain intensity. It is a 11 point numerical scale, corresponding to the degree of pain. 0= no pain, 1-2-3 = mild pain, 4-5-6 = moderate pain, 7-8-9-10 = severe pain. The patients will be asked to select from that 11 points numerical continuum the number that corresponds to their perceived pain intensity
Measured: 6 weeks
Headache Disability index (HDI)
This scale is intended to help discover impact of headache. It contains 27 questions in total. First two questions are about frequency of headache and remaining 25 regarding impact of headache on daily life of the person. Each question has three possible answers. "yes " will score 4 points, " sometimes" will score 2 and "no" will give 0 score. A total score of 10 - 28 is regarded as an indicator of light disability, the score of 30-48 represents moderate disability, 50-68 expresses severe disability, and 72 or above marks complete disability
Measured: 6 weeks
Flexion Rotation test (FRT)
Flexion rotation test is used to measure cervical range of motion employing a goniometer. Impairment in upper cervical spine mobility is associated with cervicogenic headache severity and disability. Measures of such mobility include the flexion-rotation test (FRT), which requires full cervical flexion and may be influenced by lower cervical spine dysfunction.
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Mar 2025
- Study start2 Jan 2025
- Primary completion2 Sep 2025 (estimated)
- Study completion15 Sep 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Cervicogenic HeadacheStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 32 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Ghulam Fatima, PHD*, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06875869
- Sponsor's protocol ID
- REC/RCR & AHS/24/0152
- Status last verified
- Mar 2025
- First submitted
- 10 Mar 2025
- Last updated
- 13 Mar 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Page P. Cervicogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther. 2011 Sep;6(3):254-66.
PubMed 22034615Knackstedt H, Bansevicius D, Aaseth K, Grande RB, Lundqvist C, Russell MB. Cervicogenic headache in the general population: the Akershus study of chronic headache. Cephalalgia. 2010 Dec;30(12):1468-76. doi: 10.1177/0333102410368442. Epub 2010 May 19.
PubMed 20974607Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. Lancet Neurol. 2009 Oct;8(10):959-68. doi: 10.1016/S1474-4422(09)70209-1.
PubMed 19747657Garcia JD, Arnold S, Tetley K, Voight K, Frank RA. Mobilization and Manipulation of the Cervical Spine in Patients with Cervicogenic Headache: Any Scientific Evidence? Front Neurol. 2016 Mar 21;7:40. doi: 10.3389/fneur.2016.00040. eCollection 2016.
PubMed 27047446Olesen J. International Classification of Headache Disorders. Lancet Neurol. 2018 May;17(5):396-397. doi: 10.1016/S1474-4422(18)30085-1. Epub 2018 Mar 14. No abstract available.
PubMed 29550365
Study at a glance
From the registry record, last updated by the sponsor on 13 Mar 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Jones and Ischemic Compression Technique on Pain, Range of Motion and Disability in Patients With Cervicogenic Headache
- ClinicalTrials.gov ID
- NCT06875869
- Acronym / sponsor ID
- REC/RCR & AHS/24/0152
- Conditions
- Cervicogenic Headache
- Keywords
- Cervicogenic headache, Disability evaluation, Ischemic compression therapy, Pain assessment, Range of motion, Trigger point
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 32 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 2 Jan 2025 (actual)
- Primary completion
- 2 Sep 2025 (estimated)
- Study completion
- 15 Sep 2025 (estimated)
- First posted
- 13 Mar 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary objective of the study is to determine the effects of Jones and Ischemic compression technique on pain, range of motion and disability in patients with cervicogenic headache. Cervicogenic headache is a distinctive type of secondary headache where the pain originates from structures in the neck or cervical spine and radiates to the head. Trigger point release has been associated with decrease in symptoms of patients with cervicogenic headache. This study will be a randomized clinical trial with the sample size of 32 patients. Participants will be randomly allocated into two groups: Group A and Group B. The setting of the study will be Bahawal Victoria Hospital, Bahawalpur. Group A will receive Jones technique of trigger points of the upper trapezius and sternocleidomastoid muscle while Group B will receive ischemic compression of the trigger points of the upper trapezius and sternocleidomastoid muscle. Patients of both groups will receive two treatment sessions per week for 6 weeks. Both groups will receive hot pack for 10 minutes, TENS for 15 minutes and strengthening exercises for deep neck flexors (chin tuck and head raise with ten repetitions of 10-second duration, with a 10-second rest interval between each contraction) as baseline treatment protocol. NPRS, HDI and FRT will be used as outcome measure tools. Data will be analyzed using SPSS version 25.0 with the p-value of <0.05 taken as significant difference.
Detailed description
Cervicogenic headache (CGH) is a secondary headache caused by a disorder of the cervical spine and its disc or bony and/or periarticular components and is often accompanied by neck pain The prevalence cervicogenic headache of in the general population has been reported to be 2.2%-4.1% and appears to predominate in women four times more than in men. Noninvasive treatment techniques consist mainly of electrotherapy, manual therapy (MT), and exercise prescription. Myofascial Trigger Point (MTrP) activity is one of the leading causes of CGH. Jones technique and Ischemic compression ( IC) are two treatment options for trigger points. Cervicogenic headaches are a growing problem impacting daily life, research on cervicogenic headaches is crucial to understand the link between neck issues and headaches, and develop more effective long-term treatment options. In view of the above, the current study aims to evaluate the effectiveness of Physiotherapy interventions i.e. Jones and Ischemic compression technique for Myofascial Trigger Points (MTrPs) of Sternocleidomastoid and upper Trapezius in treating cervicogenic headache.
The current study will help us in determining whether use of these techniques has any significant advantage over conventional treatment for pan and disability in CGH patients. Understanding the most effective therapeutic approach can guide practitioners in selecting evidence-based interventions, ultimately improving the overall well-being of patients suffering from cervicogenic headache.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group-A (Jones technique) | Experimental | Other: Jones techniquePatients will receive Jones technique for the Sternocleidomastoid and upper fibers of Trapezius. |
| Group-B (Ischemic compression therapy) | Active comparator | Other: Ischemic compression therapyPatients will receive Ischemic compression for the Sternocleidomastoid and upper fibers of Trapezius |
Who may qualify
- Ages
- 25 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Both males and females
- 25-35 years of age
- Individuals satisfying the Cervicogenic Headache criteria
- Positive Simon's criteria for trigger points
Key exclusion criteria (6 listed)
- primary headaches (i.e., migraine, tension type headache)
- bilateral headache
- Presence of any red flags
- cervical spinal stenosis
- evidence of central nervous system involvement
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Jones techniqueIn the Jones technique, pressure will be applied on the tender point and the patient's head will be flexed laterally to the side of the tender point, followed by a shoulder abduction of approximately 90 degrees. This position will be held for 90 s and then patient position will be passively returned to the initial position. This will be repeated three times in each session. Patients will receive two treatment sessions per week for 6 weeks | Other | Group-A (Jones technique) |
| Ischemic compression therapyPatients will receive ischemic compression of the trigger points of the upper trapezius and sternocleidomastoid muscle with hold time varying between 30 seconds to 1 minute repeated 3 to 5 times in each session. Patients will receive two treatment sessions per week for 6 weeks | Other | Group-B (Ischemic compression therapy) |
Primary outcome
Numeric Pain Rating Scale (NPRS)
Time frame: 6 weeks
It is a standardized self-reporting scale consisting of a horizontal line used to estimate the subjective level of pain intensity. It is a 11 point numerical scale, corresponding to the degree of pain. 0= no pain, 1-2-3 = mild pain, 4-5-6 = moderate pain, 7-8-9-10 = severe pain. The patients will be asked to select from that 11 points numerical continuum the number that corresponds to their perceived pain intensity
Headache Disability index (HDI)
Time frame: 6 weeks
This scale is intended to help discover impact of headache. It contains 27 questions in total. First two questions are about frequency of headache and remaining 25 regarding impact of headache on daily life of the person. Each question has three possible answers. "yes " will score 4 points, " sometimes" will score 2 and "no" will give 0 score. A total score of 10 - 28 is regarded as an indicator of light disability, the score of 30-48 represents moderate disability, 50-68 expresses severe disability, and 72 or above marks complete disability
Flexion Rotation test (FRT)
Time frame: 6 weeks
Flexion rotation test is used to measure cervical range of motion employing a goniometer. Impairment in upper cervical spine mobility is associated with cervicogenic headache severity and disability. Measures of such mobility include the flexion-rotation test (FRT), which requires full cervical flexion and may be influenced by lower cervical spine dysfunction.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Mar 2025.
- Background: PubMed 22034615Page P. Cervicogenic headaches: an evidence-led approach to clinical management. Int J Sports Phys Ther. 2011 Sep;6(3):254-66.
- Background: PubMed 20974607Knackstedt H, Bansevicius D, Aaseth K, Grande RB, Lundqvist C, Russell MB. Cervicogenic headache in the general population: the Akershus study of chronic headache. Cephalalgia. 2010 Dec;30(12):1468-76. doi: 10.1177/0333102410368442. Epub 2010 May 19.
- Background: PubMed 19747657Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. Lancet Neurol. 2009 Oct;8(10):959-68. doi: 10.1016/S1474-4422(09)70209-1.
- Background: PubMed 27047446Garcia JD, Arnold S, Tetley K, Voight K, Frank RA. Mobilization and Manipulation of the Cervical Spine in Patients with Cervicogenic Headache: Any Scientific Evidence? Front Neurol. 2016 Mar 21;7:40. doi: 10.3389/fneur.2016.00040. eCollection 2016.
- Background: PubMed 29550365Olesen J. International Classification of Headache Disorders. Lancet Neurol. 2018 May;17(5):396-397. doi: 10.1016/S1474-4422(18)30085-1. Epub 2018 Mar 14. No abstract available.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Ghulam Fatima, PHD* principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Jones technique and Ischemic compression therapy in people with Cervicogenic Headache, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 13 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Imran Amjad, PHD* (03324390125, imran.amjad@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale (NPRS) (time frame: 6 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06875869, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Mar 2025.