Cervicogenic HeadacheNCT07911254
Comparative Effects of Dynamic Cupping and Facilitated Positional Release in Cervicogenic Headache
A study testing Dynamic Cupping and Facilitated Positional Release technique in people with Cervicogenic Headache, run by University of Management and Technology Lahore at 1 site in Pakistan.
Trial summary
Cervicogenic headache (CGH) is a secondary headache disorder originating from structural and functional impairments of the cervical spine, accounting for approximately 15-20% of all chronic headaches worldwide. Read more about this study
- Who is it for?
- Ages 20 to 45 years
- Conditions the study is for
- Cervicogenic Headache
- What is being tested?
- Dynamic Cupping and Facilitated Positional Release technique
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 41 participants
- Where
- 1 sitePakistan
- Study dates
- 27 Oct 2026to 31 Dec 2026
- 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 20 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Participants aged between 20-45 years (both male and female) suffering from Cervicogenic Headache (>3 months)
- Clinically diagnosed with CGH according to ICHD-3 criteria.
- Patients with pain intensity ≥3 on a Numeric Pain Rating Scale (NPRS)
- Neck Disability Index (NDI) score ≥ 10% (mild to severe disability)
- Positive Cervical Flexion Rotation Test. (26)
Who cannot join
- Any history of cervical spine trauma, fracture, or recent surgery.
- Diagnosis of migraine, tension-type headache, or cluster headache
- Any cervical spine pathology e.g., cervical Disc bulge or Herniation, radiculopathy, cervical myelopathies and arthropathies.
- Diagnosed inflammatory, infectious, or malignant conditions affecting the cervical spine.
- Skin conditions or open wounds that contraindicate use of Dynamic cupping e.g., open wounds, skin infections and burns etc. (26)
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
Official title: COMPARATIVE EFFECTS OF DYNAMIC CUPPING AND FACILITATED POSITIONAL RELEASE ON PAIN, HEADACHE IMPACT, CERVICAL ROM, NECK DISABILITY, AND SLEEP QUALITY IN PATIENTS WITH CERVICOGENIC HEADACHE
Cervicogenic headache (CGH) is a secondary headache disorder originating from structural and functional impairments of the cervical spine, accounting for approximately 15-20% of all chronic headaches worldwide. It is characterized by unilateral head pain referred from the osseous, discal, or soft tissue elements of the upper cervical spine, frequently accompanied by restricted cervical range of motion, myofascial tenderness, significant neck disability, and disrupted sleep quality. Due to prolonged poor posture, repetitive neck movements, and increased sedentary lifestyles, the prevalence of cervicogenic headache has increased significantly in recent years. Although various physiotherapy interventions are available for its management, identifying the most effective conservative treatment approach remains a challenge due to the multifactorial nature and complexity of the condition, highlighting the need for further research. This study therefore aims to conduct the first randomized clinical trial directly comparing the effects of Dynamic Cupping and Facilitated Positional Release across five clinically relevant, multidimensional outcomes in patients with cervicogenic headache specifically pain intensity, headache impact, cervical range of motion, neck disability, and sleep quality.
The study design will be a randomized clinical trial. Non-probability Consecutive sampling technique will be used, and participants will be randomly allocated into two groups. Evaluation will be done using the Numeric Pain Rating Scale (NPRS), Headache Impact Test (HIT-6), Universal Goniometer (UG), Neck Disability Index (NDI), and Pittsburgh Sleep Quality Index (PSQI). Group A will receive Dynamic Cupping therapy, while Group B will receive Facilitated Positional Release technique. Both groups will receive three treatment sessions per week over four weeks, totaling 12 sessions, alongside a standardized baseline conventional therapy comprising hot pack application and cervical muscle stretches and Isometrics. Measurements of all outcome variables will be taken at baseline and after 4 weeks. The collected data will be analyzed using SPSS version 25.
- Conditions
- Cervicogenic Headache
- Being tested
- Dynamic Cupping, Facilitated Positional Release technique
- Keywords
- Dynamic cupping, Facilitated Positional Release, Cervical range of motion, Pain intensity, Headache impact, Neck Disability Index, Sleep quality
- Medical subject headings
- Post-Traumatic Headache, Pain, Sleep Initiation and Maintenance Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dynamic CuppingOther
Dynamic Cupping was applied using small sized silicone cups with a gliding technique over massage oil or gel. The target areas included the suboccipital region, upper trapezius and levator scapulae with suction maintained at a mild to moderate level according to patient tolerance. Intervention was delivered 3 sessions per week over 4 weeks, totaling 12 treatment sessions.
Facilitated Positional Release techniqueOther
Facilitated Positional Release technique will be applied targeting tender points in the suboccipital region, upper trapezius and levator scapulae. The affected area will be placed in a position of ease to reduce tension, followed by the application of a facilitating force such as compression or rotation for 3-5 seconds to further reduce tissue tension, with the patient positioned supine throughout. Intervention was delivered 3 times per week for 4 weeks, comprising 12 total treatment sessions.
| Study group | Role | What they receive |
|---|---|---|
| Dynamic Cupping | Experimental | Dynamic Cupping was applied using small sized silicone cups with a gliding technique over massage oil or gel. The target areas included the suboccipital region, upper trapezius and levator scapulae with suction maintained at a mild to moderate level according to patient tolerance. Intervention was delivered 3 sessions per week over 4 weeks, totaling 12 treatment sessions. Receives: Other: Dynamic Cupping |
| Facilitated Positional Release technique | Active comparator | Facilitated Positional Release technique will be applied targeting tender points in the suboccipital region, upper trapezius and levator scapulae. The affected area will be placed in a position of ease to reduce tension, followed by the application of a facilitating force such as compression or rotation for 3-5 seconds to further reduce tissue tension, with the patient positioned supine throughout. Intervention was delivered 3 times per week for 4 weeks, comprising 12 total treatment sessions. Receives: Other: Facilitated Positional Release technique |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale
The patient is asked to rate their pain by selecting a value on the scale. An 11-point numerical rating scale is used, where "0" indicates no pain and "10" represents the worst pain imaginable at the time of assessment. (27)
Measured: Baseline and after 4 weeks
Headache Impact Test-6 (HIT-6)
The HIT-6 is a six-item questionnaire designed to assess the impact of headaches. Each item is rated on a five-point Likert scale, with responses scored as never (6), rarely (8), sometimes (10), very often (11), and always (13). The scale scores can range between 36 and 78. A score of ≤49 indicates no impact (Grade I), 50-55 represents moderate impact (Grade II), 56-59 indicates significant impact (Grade III), and a score of ≥60 signifies severe impact (Grade IV). The tool evaluates overall quality of life by examining two main domains: pain-related effects, including severity and functional limitation, and psychological and social consequences such as vitality, cognition, role performance, and social functioning. HIT-6 is widely recognized as a reliable and valid measure for assessing headache-related disability. (28) (29)
Measured: Baseline and after 4 weeks
Universal Goniometer (UG)
The range of motion will be measured using a universal goniometer which is a 12-inch transparent plastic model, featuring a protractor scale, two arms, and a fulcrum that has an inter-rater reliability (ICC2, 2 = 0.79 to 0.92) for cervical region. UG requires a high level of examiner proficiency and involves the use of a measurement scale, although the final position does not need to be maintained for immediate reading, as the score can be recorded after completion. The procedure depends on accurate alignment of three anatomical landmarks: the axis, the stationary arm, and the movable arm which requires precise identification of anatomical structures. (30)
Measured: Baseline and after 4 weeks
Neck Disability Index (NDI)
It is a self-reported questionnaire comprising 10 items used to assess the level of disability associated with neck pain. It evaluates various aspects of daily functioning, including pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleep, and recreational activities. Each item is scored from 0 to 5, with higher scores reflecting greater disability, resulting in a total possible score of 50. Based on the total score, disability is classified as no disability (0-4), mild disability (5-14), moderate disability (15-24), severe disability (25-34), and complete disability (35 or above). The NDI is a valid and reliable instrument that can be interpreted using either continuous scores or categorical disability levels. (31)
Measured: Baseline and after 4 weeks
Pittsburgh Sleep Quality Index (PSQI)
It is a 19-item self-report questionnaire that assesses sleep quality and sleep-related problems over the previous month. It evaluates areas such as perceived sleep quality, sleep habits, and sleep disturbances. An additional five questions completed by a bed partner may provide clinical information but are not included in scoring. PSQI scoring generates seven component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Each component is scored from 0 (no difficulty) to 3 (severe difficulty), producing a global score ranging from 0 to 21. Higher scores indicate poorer sleep quality, and a total score above 5 is generally considered evidence of poor sleep quality. (32)
Measured: Baseline and after 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Nov 2026
- Study start27 Oct 2026 (estimated)
- Primary completion31 Dec 2026 (estimated)
- Study completion31 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- 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
- Model description
- Cervicogenic headache (CGH) is a secondary headache disorder originating from structural and functional impairments of the cervical spine, accounting for approximately 15-20% of all chronic headaches worldwide. It is characterized by unilateral head pain referred from the osseous, discal, or soft tissue elements of the upper cervical spine, frequently accompanied by restricted cervical range of motion, myofascial tenderness, significant neck disability, and disrupted sleep quality. Due to prolonged poor posture, repetitive neck movements, and increased sedentary lifestyles, the prevalence of cervicogenic headache has increased significantly in recent years. Although various physiotherapy interventions are available for its management, identifying the most effective conservative treatment approach remains a challenge due to the multifactorial nature and complexity of the condition, highlighting the need for further research. This study therefore aims to conduct the first randomized clin
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 41 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Management and Technology Lahore
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07911254
- Sponsor's protocol ID
- RE-158-2026
- Status last verified
- Oct 2026
- First submitted
- 26 Oct 2026
- Last updated
- 2 Nov 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The results data collected , de-identified individual participant data will be shared.
Study at a glance
From the registry record, last updated by the sponsor on 2 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- COMPARATIVE EFFECTS OF DYNAMIC CUPPING AND FACILITATED POSITIONAL RELEASE ON PAIN, HEADACHE IMPACT, CERVICAL ROM, NECK DISABILITY, AND SLEEP QUALITY IN PATIENTS WITH CERVICOGENIC HEADACHE
- ClinicalTrials.gov ID
- NCT07911254
- Acronym / sponsor ID
- RE-158-2026
- Conditions
- Cervicogenic Headache
- Keywords
- Dynamic cupping, Facilitated Positional Release, Cervical range of motion, Pain intensity, Headache impact, Neck Disability Index, Sleep quality
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 41 participants (estimated)
- Lead sponsor
- University of Management and Technology LahoreUniversity, hospital or other
- Study start
- 27 Oct 2026 (estimated)
- Primary completion
- 31 Dec 2026 (estimated)
- Study completion
- 31 Dec 2026 (estimated)
- First posted
- 2 Nov 2026 (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.
Cervicogenic headache (CGH) is a secondary headache disorder originating from structural and functional impairments of the cervical spine, accounting for approximately 15-20% of all chronic headaches worldwide. It is characterized by unilateral head pain referred from the osseous, discal, or soft tissue elements of the upper cervical spine, frequently accompanied by restricted cervical range of motion, myofascial tenderness, significant neck disability, and disrupted sleep quality. Due to prolonged poor posture, repetitive neck movements, and increased sedentary lifestyles, the prevalence of cervicogenic headache has increased significantly in recent years. Although various physiotherapy interventions are available for its management, identifying the most effective conservative treatment approach remains a challenge due to the multifactorial nature and complexity of the condition, highlighting the need for further research. This study therefore aims to conduct the first randomized clinical trial directly comparing the effects of Dynamic Cupping and Facilitated Positional Release across five clinically relevant, multidimensional outcomes in patients with cervicogenic headache specifically pain intensity, headache impact, cervical range of motion, neck disability, and sleep quality.
The study design will be a randomized clinical trial. Non-probability Consecutive sampling technique will be used, and participants will be randomly allocated into two groups. Evaluation will be done using the Numeric Pain Rating Scale (NPRS), Headache Impact Test (HIT-6), Universal Goniometer (UG), Neck Disability Index (NDI), and Pittsburgh Sleep Quality Index (PSQI). Group A will receive Dynamic Cupping therapy, while Group B will receive Facilitated Positional Release technique. Both groups will receive three treatment sessions per week over four weeks, totaling 12 sessions, alongside a standardized baseline conventional therapy comprising hot pack application and cervical muscle stretches and Isometrics. Measurements of all outcome variables will be taken at baseline and after 4 weeks. The collected data will be analyzed using SPSS version 25.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Cervicogenic headache (CGH) is a secondary headache disorder originating from structural and functional impairments of the cervical spine, accounting for approximately 15-20% of all chronic headaches worldwide. It is characterized by unilateral head pain referred from the osseous, discal, or soft tissue elements of the upper cervical spine, frequently accompanied by restricted cervical range of motion, myofascial tenderness, significant neck disability, and disrupted sleep quality. Due to prolonged poor posture, repetitive neck movements, and increased sedentary lifestyles, the prevalence of cervicogenic headache has increased significantly in recent years. Although various physiotherapy interventions are available for its management, identifying the most effective conservative treatment approach remains a challenge due to the multifactorial nature and complexity of the condition, highlighting the need for further research. This study therefore aims to conduct the first randomized clin
| Arm | Type | Receives |
|---|---|---|
| Dynamic Cupping | Experimental | Other: Dynamic CuppingDynamic Cupping was applied using small sized silicone cups with a gliding technique over massage oil or gel. The target areas included the suboccipital region, upper trapezius and levator scapulae with suction maintained at a mild to moderate level according to patient tolerance. Intervention was delivered 3 sessions per week over 4 weeks, totaling 12 treatment sessions. |
| Facilitated Positional Release technique | Active comparator | Other: Facilitated Positional Release techniqueFacilitated Positional Release technique will be applied targeting tender points in the suboccipital region, upper trapezius and levator scapulae. The affected area will be placed in a position of ease to reduce tension, followed by the application of a facilitating force such as compression or rotation for 3-5 seconds to further reduce tissue tension, with the patient positioned supine throughout. Intervention was delivered 3 times per week for 4 weeks, comprising 12 total treatment sessions. |
Who may qualify
- Ages
- 20 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Participants aged between 20-45 years (both male and female) suffering from Cervicogenic Headache (>3 months)
- Clinically diagnosed with CGH according to ICHD-3 criteria.
- Patients with pain intensity ≥3 on a Numeric Pain Rating Scale (NPRS)
- Neck Disability Index (NDI) score ≥ 10% (mild to severe disability)
- Positive Cervical Flexion Rotation Test. (26)
Key exclusion criteria (5 listed)
- Any history of cervical spine trauma, fracture, or recent surgery.
- Diagnosis of migraine, tension-type headache, or cluster headache
- Any cervical spine pathology e.g., cervical Disc bulge or Herniation, radiculopathy, cervical myelopathies and arthropathies.
- Diagnosed inflammatory, infectious, or malignant conditions affecting the cervical spine.
- Skin conditions or open wounds that contraindicate use of Dynamic cupping e.g., open wounds, skin infections and burns etc. (26)
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 |
|---|---|---|
| Dynamic CuppingDynamic Cupping was applied using small sized silicone cups with a gliding technique over massage oil or gel. The target areas included the suboccipital region, upper trapezius and levator scapulae with suction maintained at a mild to moderate level according to patient tolerance. Intervention was delivered 3 sessions per week over 4 weeks, totaling 12 treatment sessions. | Other | Dynamic Cupping |
| Facilitated Positional Release techniqueFacilitated Positional Release technique will be applied targeting tender points in the suboccipital region, upper trapezius and levator scapulae. The affected area will be placed in a position of ease to reduce tension, followed by the application of a facilitating force such as compression or rotation for 3-5 seconds to further reduce tissue tension, with the patient positioned supine throughout. Intervention was delivered 3 times per week for 4 weeks, comprising 12 total treatment sessions. | Other | Facilitated Positional Release technique |
Primary outcome
Numeric Pain Rating Scale
Time frame: Baseline and after 4 weeks
The patient is asked to rate their pain by selecting a value on the scale. An 11-point numerical rating scale is used, where "0" indicates no pain and "10" represents the worst pain imaginable at the time of assessment. (27)
Headache Impact Test-6 (HIT-6)
Time frame: Baseline and after 4 weeks
The HIT-6 is a six-item questionnaire designed to assess the impact of headaches. Each item is rated on a five-point Likert scale, with responses scored as never (6), rarely (8), sometimes (10), very often (11), and always (13). The scale scores can range between 36 and 78. A score of ≤49 indicates no impact (Grade I), 50-55 represents moderate impact (Grade II), 56-59 indicates significant impact (Grade III), and a score of ≥60 signifies severe impact (Grade IV). The tool evaluates overall quality of life by examining two main domains: pain-related effects, including severity and functional limitation, and psychological and social consequences such as vitality, cognition, role performance, and social functioning. HIT-6 is widely recognized as a reliable and valid measure for assessing headache-related disability. (28) (29)
Universal Goniometer (UG)
Time frame: Baseline and after 4 weeks
The range of motion will be measured using a universal goniometer which is a 12-inch transparent plastic model, featuring a protractor scale, two arms, and a fulcrum that has an inter-rater reliability (ICC2, 2 = 0.79 to 0.92) for cervical region. UG requires a high level of examiner proficiency and involves the use of a measurement scale, although the final position does not need to be maintained for immediate reading, as the score can be recorded after completion. The procedure depends on accurate alignment of three anatomical landmarks: the axis, the stationary arm, and the movable arm which requires precise identification of anatomical structures. (30)
Neck Disability Index (NDI)
Time frame: Baseline and after 4 weeks
It is a self-reported questionnaire comprising 10 items used to assess the level of disability associated with neck pain. It evaluates various aspects of daily functioning, including pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleep, and recreational activities. Each item is scored from 0 to 5, with higher scores reflecting greater disability, resulting in a total possible score of 50. Based on the total score, disability is classified as no disability (0-4), mild disability (5-14), moderate disability (15-24), severe disability (25-34), and complete disability (35 or above). The NDI is a valid and reliable instrument that can be interpreted using either continuous scores or categorical disability levels. (31)
Pittsburgh Sleep Quality Index (PSQI)
Time frame: Baseline and after 4 weeks
It is a 19-item self-report questionnaire that assesses sleep quality and sleep-related problems over the previous month. It evaluates areas such as perceived sleep quality, sleep habits, and sleep disturbances. An additional five questions completed by a bed partner may provide clinical information but are not included in scoring. PSQI scoring generates seven component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Each component is scored from 0 (no difficulty) to 3 (severe difficulty), producing a global score ranging from 0 to 21. Higher scores indicate poorer sleep quality, and a total score above 5 is generally considered evidence of poor sleep quality. (32)
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 2 Nov 2026.
- Cervicogenic headache - How to recognize and treatLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. The results data collected , de-identified individual participant data will be shared.
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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.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Dynamic Cupping and Facilitated Positional Release technique in people with Cervicogenic Headache, run by University of Management and Technology Lahore 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 5 inclusion and 5 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: opening soon, as of the sponsor's last update on 2 Nov 2026. 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?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale (time frame: Baseline and after 4 weeks). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 2 Nov 2026.