• 대한정형도수물리치료학회지
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• 제29권1호
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• pp.81-93
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• 2023

Purpose: The current case study focuses on identifying the effects of manual therapy and home self-therapeutic exercise including on mouth opening and pain relief in patients with continuous neck pain with myofascial temporomandibular disorders (TMDs) accompanied by headache induced by masticatory myalgia Subjects: The study participant was a 27-year-old woman who was treated a year ago for pain related to TMDs accompanied by a headache. Methods: Manual therapy of the cervical spine with upper cervical spine posterior-to-anterior mobilization (C1~C2), upper cervical spine flexion mobilization (C0~C2), upper cervical spine lateral flexion mobilization (C0~C1), upper cervical spine thrust manual therapy (C1~C2) and manual therapy of the temporomandibular joint and muscles with transverse medial accessory temporomandibular joint mobilization, manual therapies for the temporal, the masseter, and medial pterygoid muscles were performed twice a week for about 30 minutes for 4 weeks. This protocol included 3 sessions in total. The home self-therapeutic exercise was to be performed two to three times a day. Results: The values more improved MMO increased to 41.4 mm, left masseter muscle PPT to 2.9 kgf/cm², right masseter muscle PPT to 3.1 kgf/cm², KHIT-6 to 46 points, neck pain intensity (by NRS) to 2 points, headache frequency to per weeks, cervical kyphotic angle to -8.06%, and GCPS to grade 1 (low-intensity pain without pain-related disorder). Conclusion: Manual therapy and home self-therapeutic exercise can be helpful for mouth opening and pain relief in patients with myofascial TMDs accompanied by secondary headaches induced by masticatory myalgia.

• The Korean Journal of Pain
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• 제12권2호
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• pp.231-234
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• 1999

Until several years ago we didn't think seriously about cervical problems as a cause of headaches, but since the publication of articles by Bogduk et al they have gotten more attention. Cervical headaches are associated with movement abnormalities of the structures of the neck such as cervical nerve roots, discs, joints and soft tissues. Considering this, we thought that the atlanto-axial joint could be one of the causes of these headaches. Headaches originating from this joint can be recognized by the fact that the pain worsens with rotation of the head in the horizontal plane. Pain can also be referred to the frontal area or around the orbit. We did atlanto-axial joint blocks using a posterior approach on 10 patients who suffered from this type of headache. The results were promising with 9 out of 10 patients showing more than 50% improvement on the numeric rating scale. There were no serious complications observed. We concluded that the atlanto-axial joint block can be an effective procedure in treating this specific type of headache.

• 대한한방소아과학회지
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• 제17권2호
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• pp.161-171
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• 2003

This study was to investigate the relationship of headache and back shape using the Moire interferometer and Questionnaire investigations. In this study the subjects consisted of 317 pupils[168 boys(53%), 149girls(47%)] attending S high school in Sungnamsi, Kyoungkido in 2002, and their ages ranged from sixteen to eighteen. The results are following. 1. In questionnaire investigation, we observed that the ratio of headache was more than 70% and the ratio of girls are more than that of boys. The inclination for ages was not shown. 2. In moire topography, the remainder values of scapular region were from 0.5 cm to 1.1 cm in boys, and from 0.45 cm to 1 cm in girls. The remainder values of gluteal region were from 0.2 cm to 0.8 cm in boys, and from 0.4 cm to 0.6 cm in girls. The reminder values of the vertical lines of cervical and buttock region were from 0.71 cm to 1.51 cm in boys, and from 0.96 cm to 1.43 cm in girls. More frequent findings of reminder value of the vertical lines of cervical and buttock region were observed that the vertical lines of cervical region were inclined to left than the vertical lines of buttock 3. Through the Pearson's Correlation analysis of headache and Moire topography, we found the close relationship of headache and the remainder values of scapular region(Pearson correlation coefficient : 0.116, P<0.05) and gluteal region(Pearson correlation coefficient : 0.153, P<0.01). But the relevances to headache and the remainder values of neck lines, sacral lines and neck-sacral lines were not found.

• Journal of Acupuncture Research
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• 제18권6호
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• pp.114-124
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• 2001

Objective : To evaluate the effect of treatment for cervical headache by using Cathami Flos herbal acupuncture that are known for anti-inflammatory and function of relieving the pain. Methods : Evaluated the result of Cathami Flos herbal acupuncture treatment twice in a week for patients who have cervical headache with cervical MRI abnormality at Gun-Po Oriental medical hospital in affiliation with wonkwang university. Results : 1. In the distribution of sex; Female rate was 45.9% and male rate was 54.1%., In the distribution of age, Thirties and forties group was the largest group by each 32.8%. 2. In the distribution of Cervical MRI abnormality; Abnormality of C2/3, C3/4, C4/5 was 94.6%, disk bulging and disk protrusion was 94.5%. 3. The effect of treatment by age was as follows; Thirties and forties group were each 31.1%, total 62.2%. 4. In the distribution of treatment period and curative value; 'Two weeks to four week' was 63.9%. Conclusion : These results shows that it is possible for headache to be occurred by cervical abnormality and that the effect of treatment by Cathami Flos herbal acupuncture is exellent by relaxing contracted muscles, strengthening weakened' ligaments and improving inflammatory parts.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.49-56
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• 2010

Purpose: The aim of this study was to evaluate a possible role for cranial artery velocity in cervicogenic headache. Methods: We studied 13 patients with cervicogenic headaches (M=9, F=4, age=$24.50{\pm}3.50\;y$) these were compared to 20 normal subjects (M=10, F=10, age=$23.30{\pm}2.90\;y$). Cervicogenic headache patients were divided into two groups (a myofascial relaxation group, a placebo group). Pain levels were measured using a visual analog scale (VAS). Transcranial Doppler (TCD) ultrasound recordings were used to measure blood flow velocity in the cranial artery. Results: Cervicogenic headache patients exhibited a significantly lower blood flow velocity in the middle cerebral artery. The patients who received an intervention had a significantly higher blood flow velocity in the left middle cerebral artery, right vertebral artery and basilar artery. Compared to the placebo group, the myofascial relaxation group exhibited a significantly decreased level of pain. Conclusion: Cervicogenic headache is pain referred to the head from a source in the cervical spine. Manual therapy affect to cervical spine and soft tissue as well as the passage of these vessels and nerves to recover because it is thought to be able to help.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.215-221
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• 2020

Objective: Tension-type headaches usually occur with temporomandibular disorder, which increases the risk of the chronic tension-type headaches. This study was conducted to investigate the effect of additional temporalmandibular therapy compared to cerivcal joint therapy for tension-type headaches with pericranial tenderness. Design: Randomized controlled trial. Methods: Forty-one patients with chronic tension-type headaches and pericranial tenderness were randomized into the 3 groups, such as the temporomandibular joint therapy group (TMJT group, n=14), cervical manual therapy group (CMT group, n=14) and conservative therapy group (CT group, n=13). All patients were assessed at baseline and after each intervention during the three sessions. The participants in the TMJT group received the temporomadibular joint treatment and cervical manual therapy for 30 minutes, once a week, for 3 weeks. The participants in the CMT group received the cervical manual therapy, and those in the CT group received modalities during same time period. The outcome measurements used were the intensity of headaches measured on the Visual Analogue Scale (VAS), quality of life measured with the Headache Impact Test (HIT-6), and function of the cervical spine using the Neck Diability Index (NDI). Results: The TMJT group that received temporomandibular joint treatment and cervical manual therapy showed a significant decrease in VAS, HIT-6, and NDI compared with the other 2 groups (p<0.05). Conclusions: This study suggected that temporomandibular joint treatment combined with cervical manual therapy was more effective for the chronic tension-type headaches with pericranial tenderness than the usual cervical therapy alone.

• Journal of Oral Medicine and Pain
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• 제18권1호
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• pp.9-19
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• 1993

The purpose of this study was to evaluate the effect of craniocervical posture on craniomandibular disorders with chronic headache. The author measured craniocervical posture on frontal and sagittal plane with photographs for 26 headache patients, 23 TMD patients, and 27 nonpatients. Range of cervical spine motion was also measured. The bilateral electromyograms of masseter and anterior temporalis muscles were recorded at rest and during maximum clenching. The results were as follows : On the lateral view photos, eye-tragus-C7 line angle was larger and the tragus-C7-horizontal line angle was smaller in the patient groups than in the nonpatient group (p<0.05). On the frontal view photos, mouth corner line angle was larger in the headache patient group than in the nonpatient group and TMD patient group (p<0.05) Interclavicular angle was smaller in the headache patient group and TMD patient grop than in the nonpatient (p<0.01) The right and left differences of SAIC-plane distance and finger tip-plane distance were significantly larger in headache patient group than TMD patient group and nonpatient group (p<0.01, p<0.001). Cervical motion range was smaller in the TMD patient group and headache patient group than in the nonpatient group (p<-.001, p<0.05, p<0.05). The resting EMG activities of right masseter muscle were higher in the headache patient group than in the nonpatient group (p<0.05). However, the EMG activities of masseter and anterior temporalis muscles during maximal clenching were lower in the patient group than in the nonpatient grop (p<0.01). The asymmetry index of resting EMG of masseter muscles was higher in the headache patient group than nonpatient group (p<0.05).

• The Korean Journal of Pain
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• 제12권1호
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• pp.157-161
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• 1999

We report a patient with spontaneous intracranial hypotension. In addition to the cardinal feature of a postural headache and a low CSF pressure, the patient also had subdural hematoma demonstrated by brain MRI. Radionuclide cisternography revealed a CSF leakage in the intracranium. CSF leakage from spinal meningeal defects may be the most common cause of this syndrome. The headache is a consequence of the low CSF pressure producing displacement of pain-sensitive structures. Methods of treatment are identical to those for post-dural puncture headaches. We experienced a patient with spontaneous intracranial hypotension developed in the intracranium who was successfully managed with a cervical blood patch.

• 대한통합의학회지
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• 제7권4호
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• pp.301-309
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• 2019

Purpose : The purpose of this study was to provide an effective method of exercise therapy for patients with cervicogenic headache. Methods : The subjects were divided into the following two groups according to the intervention received: cervical stretch exercise (n=15, control group) cervix-stabilizing exercise (n=15, experimental group) tone (Hz) and stiffness (N/m) of the suboccipital and upper trapezius muscles were measured. T1 slope angle and neck tilt angle were measured. After the exercise program intervention, a greater amount of change in muscle tone and stiffness of suboccipital and upper trapezius muscles was found in the experimental group, as compared to the control group. Greater amount of change in posture was found in the experimental group, as compared to the control group (p<0.05). Results : After the exercise program intervention, a greater amount of change in muscle tone and stiffness of suboccipital and upper trapezius muscles was found in the experimental group, as compared to the control group. Greater amount of change in posture was found in the experimental group, as compared to the control group (p<0.05). Conclusion : The neck-stabilizing exercise were shown to be effective in decreasing the tone of the cervical muscles by stabilizing the cervical bone and improving muscle activity, and in improving the posture by decreasing muscle tone and stiffness.

• Physical Therapy Rehabilitation Science
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• 제8권4호
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• pp.202-209
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• 2019

Objective: The purpose of this study was to evaluate the effects of temporomandibular joint and cervical vertebra treatment in persons with tension-type headaches on pain, tenderness, and functional improvement. Design: Three-group pretest-posttest design. Methods: Subjects with tension-type headaches were divided into the temporomandibular joint and cervical vertebra treatment group (n=11), temporomandibular joint treatment group (n=11), and cervical vertebra treatment group (n=11), and pre- and post-evaluation was performed. The temporomandibular joint treatment group underwent compression massage and joint ply of the muscles around the temporomandibular joint. The cervical vertebra group received deep tendon massage and Myofascial Release of the cervical muscles. The temporomandibular joint and cervical vertebra treatment group performed both types of treatment. Treatment was performed for 50 minutes, three times a week for 4 weeks. Measurement tools included the Korean version of the short form-McGill Pain Questionnaire (SF-MPQ, K), Headache Impact test-6 (HIT-6), Neck Disability Index (NDI), and the Digital Algometer FPX25. Results: The groups showed significant differences in SF-MPQ, HIT-6 test, NDI, and Alogometer FPX25 test scores before and after intervention (p<0.05). The differences between the groups were most significant in the group that received treatment of the temporomandibular joint and cervical vertebra (p<0.05). Conclusions: In this study, the treatment of the temporomandibular joint and cervical vertebra was shown to be effective for improving pain, quality of life, and cervical vertebra in persons with tension-type headaches. This data may be helpful in identifying treatment techniques for tension-type headaches in the future.