Efficacy of Dry Needling Versus Cranial Osteopathic Manipulative Therapy in Patients with Cervicogenic Headache: A Pilot Randomized Controlled Feasibility Trial.

Abstract

Background: Cervicogenic headache (CGH) is a secondary headache disorder originating from cervical spine pathology, characterized by pain that radiates from the cervical region to the head.Manual therapies and physiotherapy constitute established treatment modalities; however, their efficacy remains inconsistent across published literature. Emerging therapeutic approaches, including dry needling (DN) and cranial osteopathic manipulative therapy (COMT), demonstrate potential clinical utility; however, comparative effectiveness studies remain limited in the existing literature. Materials and Methods:The primary goals of this pilot trial were to examine feasibility, recruitment, retention and pre-pilot estimates of treatment effect, enrolled 20 adults diagnosed with CGH according to established diagnostic criteria.Participants were randomly allocated to receive either DN or COMT interventions administered twice weekly over an eight-week period. Outcome measures included the Pain Catastrophizing Scale, Neck Disability Index , and Visual Analog Scale , assessed at baseline (pre-intervention) and immediately post-intervention. Statistical analyses comprised paired samples t-tests for within-group comparisons, Mann-Whitney U tests for between-group comparisons, and Pearson correlation analyses. Results: The results of feasibility were satisfactory in terms of adherence and retention rates with 80% of respondents completing the intervention. Neither the DN group nor the COMT group demonstrated statistically significant improvements in Pain Catastrophizing Scale, Neck Disability Index, or Visual Analog Scale scores from baseline to post-intervention assessment. Correlation analyses between baseline and post-intervention measurements revealed weak and statistically non-significant associations across all clinical measures, suggesting limited therapeutic response to both intervention modalities within the scope of this pilot investigation. Conclusions: While both dry needling and cranial osteopathic manipulative therapy demonstrate theoretical potential as therapeutic interventions for cervicogenic headache management, the results of this pilot study do not support their standalone use for achieving clinically meaningful reductions in pain or functional disability.Future research employing larger sample sizes, extended follow-up periods, and potentially multimodal treatment approaches is warranted to definitively assess the clinical utility and long-term efficacy of these interventions for CH management.