Dose Related Effects of Radial Extracorporeal Shock Wave Therapy on Upper Trapezius Trigger Points in Patients With Cervicogenic Headache: A Randomized Controlled Trial.

Abstract

This study was conducted to compare the effect of low and medium dose radial extracorporeal shock wave therapy (rESWT) on upper trapezius in patients with cervicogenic headache. It is a double-blinded, randomized controlled trial in which 135 participants aged 40- 60 years, all diagnosed with cervicogenic headache. They were randomly assigned to 3 separate groups, with each group underwent three sessions weekly for four consecutive weeks. All participants performed neck muscle stretching and strengthening exercises which considered traditional treatment, while additional interventions varied by group: Group (A) received low-dose rESWT; Group (B)received medium-dose rESWT; and Group C received a sham intervention. Significant improvements were observed in the headache disability index, visual analogue scale scores, and upper trapezius electromyographic activity with P-value <.05 in three groups, with greatest improvement in the medium dose rESWT. All three groups demonstrated effectiveness in alleviating pain and headache severity and in promoting the recovery of normal muscle activity in patients with cervicogenic headache. The medium dose rESWT showed superior outcomes, suggesting its potential clinical and research utility.