Humans ; Post-Traumatic Headache/etiology* ; Risk Factors ; Cervical Vertebrae/surgery*

OBJECTIVE: To compare therapeutic effects between nape acupuncture combined with manipulation and simple manipulation in treating cervicogenic headache, and to verify the synergistic effect of manipulation and nape acupuncture. METHODS: Total 60 patients with cervicogenic headache were divided into two groups:nape acupuncture combined with manipulation group (group A) and manipulation group(group B). There were 30 patients in group A, including 12 males and 18 females with an average age of (41.37±12.09) years old, and an average course of disease of (23.73±15.54) months;there were 30 patients in the manipulation group (group B), including 14 males and 16 females with an average age of (42.40±12.05) years old, and an average course of disease of (25.53±14.33) months. In the group A, acupuncture therapy was performed firstly at the bilateral RESULTS: There was no significant difference in the onset time of analgesia between the two groups[(5.97±3.21) min vs(7.30±3.97) min, CONCLUSION Nape needling can prolong the analgesic time of manipulation and improve the analgesic effect of manipulation.
Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Needles ; Post-Traumatic Headache ; Treatment Outcome

The manipulation and key points of professor
Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; Headache/therapy* ; Humans ; Needles ; Post-Traumatic Headache

OBJECTIVE: To investigate the clinical characteristics and mechanism of cervicogenic headache. METHODS: Fifty-seven patients with cervicogenic headache who were treated from May 2013 to December 2017 and had complete imaging data were selected, including 18 males and 39 females with an average age of(43.26±10.39) years old ranging from 20 to 63 years old. The duration of the disease was 4 months to 35 years with a mean of (11.74±9.47) years. The pain situation, iconography and Tinel sign were analyzed. RESULTS: The patients with cervicogenic headache often had bilateral pain. The regions mainly concentrated in the temporal region, with occipital, head or orbit pains. The VAS scores decreased with the duration of the disease. There were many cases of disc herniation(91.30%), vertebral instability(73.91%), atlantoaxial displacement(56.52%), curvature change of cervicogenic vertebra(54.35%). The number of positive Tinel sign points was between 3 and 24 (13.58±5.8) per patient. The number and extent of Tinel sign were significantly different between the affected side and healthy side(<0.05). C₂,₃ facet joints(92.98%), post mastoid(89.47%), occipital concavity(89.47%), C₃,₄ facet joints(84.21%), third occipital nerve(80.70%) were the positive Tinel sign points in patients with cervicogenic headache. CONCLUSIONS The iconography changes of cervicogenic headache and Tinel sign may contribute to the clinical diagnosis and mechanism of the disease.
Adult ; Cervical Vertebrae ; Female ; Humans ; Male ; Middle Aged ; Post-Traumatic Headache ; Spinal Nerves ; Young Adult

This report suggests indications, detailed procedures, clinical efficacy and safety of ultrasound (US) guided cervical interventions, such as selective nerve root block (SNRB), medical branch block (MBB), facet joint intra-articular (FJIA) injection, third occipital nerve (TON) block and greater occipital nerve (GON) block. Comparing with fluoroscopy guided transforaminal and interlaminar epidural blocks, US guided cervical interventions have similar clinical effects and superior safety. For cervical axial pain and cervicogenic headache US guided MBB or FJIA injection can be performed. Usual targets of injection are upper cervical (C2–3) for cervicogenic headache and lower cervical (C5–6) for axial neck pain. Clinical effect of US guided MBB is reported to be similar to fluoroscopy guided MBB. Instead of upper cervical (C2–3) facet joint injection, TON block is usually performed. The accuracy of US guided TON block and MBB is reported as high with confirmation of fluoroscopy. GON block can be performed for occipital neuralgia, migraine, chronic daily headache, etc. US guided GON block is much safe and supposed to be highly accurate compared with blind technique. Ultrasonography guided cervical interventions are effective to reduce pain and most of all safe procedure. We need to use ultrasonography guided intervention actively in the field of clinic.
Fluoroscopy ; Headache Disorders ; Migraine Disorders ; Neck Pain ; Nerve Block ; Neuralgia ; Post-Traumatic Headache ; Treatment Outcome ; Ultrasonography ; Zygapophyseal Joint

OBJECTIVETo compare the efficacy difference between triple acupuncture method at cervical Jiaji (EX-B 2) and conventional acupuncture for cervicogenic headache.

METHODSA total of 66 patients were randomly divided into a triple acupuncture group and a conventional acupuncture group, 33 cases in each one. The acupoints selected in the two groups were identical, including C1 to C7 of cervical Jiaji (EX-B 2) as well as Baihui (GV 20), Qiangjian (GV 18), Naokong (GB 19), Fengchi (GB 20), Fengfu (GV 16), Tianzhu (BL 10), etc. The conven- tional acupuncture was performed at acupoints on the head in the two groups; triple acupuncture was performed at cervical Jiaji (EX-B 2) in the triple acupuncture group while perpendicular acupuncture was performed with a depth of 25 to 40 mm in the conventional acupuncture group. The treatment was given once a day. Five treatments were considered as one session and totally two sessions were required. The changes of simplified McGill scale before and after acupuncture were observed in the two groups, and the efficacy of the two groups was compared.

RESULTSAfter acupuncture, the simplified McGill scale was both reduced in the two groups (both P < 0.01), and there was no significant difference between the two groups after treatment (all P > 0.05). The cured and markedly effective rate was 75.8% (25/33) and the total effective rate was 93.9% (31/33) in the triple acupuncture group, which were superior to 57.6% (19/33, P < 0.01) and 84.8% (28/33, P < 0.05) in the conventional acupuncture group respectively.

CONCLUSIONThe efficacy of triple acupuncture method at cervical Jiaji (EX-B 2) is superior to that of conventional acupuncture for cervicogenic headache.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Post-Traumatic Headache ; therapy ; Treatment Outcome

No abstract available.
Arthritis, Rheumatoid* ; Headache ; Post-Traumatic Headache*

OBJECTIVETo evaluate the clinical effects of the massage method of micro-regulating with vertical cross pressing lying on one side in treating cervicogenic headache (CEH).

METHODSTotal 136 patients with CEH were collected in the study from August 2012 to April 2014. They were divided randomly into two groups according to random digits table. Sixty-nine patients accepted the treatment of micro-regulating with vertical cross pressing lying on one side (pressing micro-regulating group), including 29 males and 40 females with an average age of (50.55 ± 11.38) years old; 67 patients received the treatment of traditional massage (traditional massage group), including 28 males and 39 females with an average age of (51.20 ± 11.90) years old. Clinical effect was observed according to the standard of curative effect of State Administration of Traditional Chinese Medicine; the function of cervical vertebra and all body status were evaluated according to NDI score. VAS score, frequency and time of headache were recorded and compared before and after treatment.

RESULTSNo adverse reactions were found after treatment, all patients were followed up from 1 to 6 months with an average of 3.1 months. In pressing micro-regulating group, 25 cases got fully recover, 26 excellence, 14 effectiveness and 4 inefficiency; and in traditional massage group, the results were 12,21,22, 12;clinical effect of pressing micro-regulating group was better than that of traditional massage group (P<0.01). NDI score in pressing micro-regulating group decreased from preoperative 13.48 ± 4.83 to postoperative 6.23 ± 3.76; in traditional massage group also decreased from preoperative 13.82 ± 5.78 to postoperative 8.25 ± 4.75; the improvement of the pressing micro-regulating group was obviously better than that of traditional massage group (P < 0.01). VAS score in pressing micro-regulating group decreased from preoperative 4.75 ± 0.97 to postoperative 1.88 ± 1.78; and in traditional massage group decreased from pre-operative 4.78 ± 0.98 to postoperative 2.84 ± 1.94; pressing micro-regulating group was more notable than that of traditional massage group (P < 0.01). The frequency per week,the pain time in pressing micro-regulating group decreased from preoperative (5.38 ± 1.96) times and (6.87 ± 3.67) hours to postoperative (1.71 ± 2.04) times and (0.97 ± 1.74) hours,respectively,in traditional massage group the above parameters decreased from preoperative (5.22 ± 1.81) times and (6.90 ± 3.79) hours to postoperative (2.81 ± 2.42) times and (1.83 ± 2.21) hours;pressing micr-regulating group was more notable than that of traditional massage group (P < 0.01 or P < 0.05).

CONCLUSIONUsing the tuina method of micro-regulating with vertical cross pressing lying on one side to treat CEH can improve function of cervical vertebra and all body status, lessen the intensity, frequency, duration time of pain, and had advantage of higher security, simple operation, and evident effect.

Adult ; Aged ; Female ; Humans ; Male ; Massage ; methods ; Middle Aged ; Physical Therapy Modalities ; Post-Traumatic Headache ; therapy

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system associated with longitudinally extensive myelitis and optic neuritis. It is characterized by relapses that lead to blindness and paralysis sequelaes. But, this is rare disease; therefore high clinical suspicion for a correct diagnosis and proper examinations are not easy. However, early diagnosis is essential to prevent sequelae. We report the case of NMO with headache. A 30-year male patient who suffered headache visited our pain clinic because of aggravated pain despite treatment. The cause of the pain was revealed as NMO by more detailed previous history and examination.
Blindness ; Central Nervous System ; Demyelinating Diseases ; Diagnosis ; Early Diagnosis ; Headache ; Humans ; Male ; Myelitis ; Neuromyelitis Optica* ; Optic Neuritis ; Pain Clinics ; Paralysis ; Post-Traumatic Headache* ; Rare Diseases ; Recurrence

Cervicogenic headache is pain from the head due to various sources in the cervical spine. The C2-3 zygapophysial joints are the most commonly involved structure, and this type of headache could be relieved by blocks or neurotomy of the third occipital nerve. A 59-years-old female patient suffered from cervicogenic headaches due to severe C2-3 zygapophysial joint hypertrophy. Her pain was partially relieved by the third occipital radiofrequency neurotomy, and was almost completely removed by C3 deep medial branch neurotomy. Herein, we report a case of osteoarthritis associated cervicogenic headaches at the C2-3 zygapophysial joints and proposed a treatment option.
Female ; Head ; Headache ; Humans ; Hypertrophy ; Joints ; Osteoarthritis* ; Post-Traumatic Headache* ; Spine ; Zygapophyseal Joint*