The role of manual correction methods and extracorporeal shock wave therapy in the prevention of chronic tension headaches

Abstract

Introduction. Tension-type headache is an urgent problem in the modern medicine due to a significant decrease in the efficiency and quality of patient′s life, despite the benign nature of the disease.The aim of the study is to develop and scientifically substantiate the comprehensive application of extracorporeal shock wave therapy and manual methods of preventive treatment of the chronic tension-type headache.Materials and methods. The prospective randomized study included 90 patients with tension-type headache (chronic), G44.2, and 20 healthy patients in the age from 24 to 50 years. Participants were divided into 3 equal groups with 30 participants in each one. In the I group the pharmacotherapy with amitriptyline was performed, in the II group — manual treatment, and in the III group — complex rehabilitation with manual methods of treatment and extracorporeal shockwave therapy. Additionally, 20 healthy patients were included in the study (group IV). To assess the treatment effectiveness the following methods were used: a headache diary, manual examination, NRS scale, HADS scale.Results. The data obtained demonstrated that the combined use of manual treatment and extracorporeal shock wave therapy, as well as single-impact manual treatment methods, contributes to clinical improvement to a greater extent than pharmacotherapy. A comparative analysis of the study groups in the long-term follow-up period (after 3 months) showed more significant results in the group with comprehensive rehabilitation, which is clearly reflected in the form of a significant decrease in pain intensity and overall pain score. The methods used significantly improved the psycho-emotional status of patients, however, pharmacotherapy with amitriptyline was accompanied by side effects.Conclusion. The comprehensive application of extracorporeal shock wave therapy and manual methods of treatment leads to a significant improvement in both clinical and psycho-emotional states of patients with tension-type headache.