Comparative Effects of Cognitive Behavioral Therapy (CBT) And Myofascial Release (MFR) along with Conventional Therapy in Patients with Cervicogenic Headache

Gayatri  Yadav; Saurabh  Kumar; Aarti  Gupta; Priyanka  Rishi

doi:10.18502/jimc.v9i1.20484

Gayatri Yadav School of Physiotherapy, SGT University, Gurugram, Haryana, India
Saurabh Kumar School of Physiotherapy, SGT University, Gurugram, Haryana, India
Aarti Gupta School of Physiotherapy, SGT University, Gurugram, Haryana, India
Priyanka Rishi School of Physiotherapy, SGT University, Gurugram, Haryana, India

DOI: https://doi.org/10.18502/jimc.v9i1.20484

Keywords: Cognitive behavioural therapy, Chronic pain, Cervical vertebrae, Headache, Myofascial release therapy, Sleep quality

Abstract

Background: Cervicogenic Headaches (CGH) are a secondary headache disorder arising from musculoskeletal issues in the cervical spine. This study explores whether combining Cognitive Behavioural Therapy (CBT) with Myofascial Release (MFR) and conventional therapy can better reduce pain, headache severity, disability, and improve sleep and quality of life in CGH patients.

Methods: A sample of 30 participants aged 25-45 yr, diagnosed with cervicogenic headache, were recruited and randomly assigned to two groups: Group A (CBT with conventional therapy) and Group B (MFR with conventional therapy). Both groups received 60-min treatment sessions, 3 days per week for 4 weeks. Outcome measures included Numeric Pain Rating Scale, Neck Disability Index (NDI), Headache Disability Index (HDI), Pittsburgh Sleep Quality Index, and quality of life. A mixed-design ANOVA was conducted to analyze the main effects of group (G), time (T), and the group-by-time interaction (G×T) for all the outcome measures.

Results: Both groups showed significant improvements post-intervention, with notable time (T) and interaction (G×T) effects across all the parameters (p<0.001). Group A demonstrated greater reductions in pain [Numeric Pain Rating Scale (NPRS), p<0.001], disability (NDI, HDI, p<0.001), and sleep disturbances [Pittsburgh Sleep Quality Index (PSQI), p<0.001], along with improved quality of life [WHO Quality of Life Scale (WHOQOL), p<0.001] and cervical posture (CV Angle, p=0.004). These findings highlight the added benefits of CBT in addressing cognitive and emotional aspects of CGH.

Conclusion: Integrating CBT with conventional therapy provides a more effective approach for managing CGH than physical therapy alone. By addressing both physical and cognitive-behavioral aspects, this multimodal approach offers promising benefits in reducing headache severity and improving functional outcomes in patients with CGH. Future studies with larger sample sizes are recommended to validate these findings and explore long-term outcomes.