Cervicogenic HeadacheCGHNCT07047313
Impact of Adding Jones Technique to Mulligan Therapy in Patients With Cervicogenic Headache
A study testing jones and mulligan therapy, mulligan therapy and exercises program in people with Cervicogenic Headache, run by Cairo University.
Trial summary
this study will be conducted to investigate impact of adding jones technique to mulligan therapy in patients with cervicogenic headache Read more about this study
- Who is it for?
- Ages 20 to 60 years
- Conditions the study is for
- Cervicogenic Headache
- What is being tested?
- jones and mulligan therapy, mulligan therapy and exercises program
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- No sites listed yet
- Study dates
- 30 Jun 2025to 30 Jan 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 20 to 60 years old patient with unilaterally of the head pain
- pain triggered by external pressure over the upper cervical joints (c1-c3)
- pain elicited by the neck movements, and/or sustained awkward positions with reduced neck ROM
- headache intensity pain score of at least 20mm on the Visual analogue scale (VAS)
- headache frequency of at least once a week for at least 3 months
- minimum neck disability index score of 10 points or greater
Who cannot join
- Migraine, tension- type headache, tumor, osteoporosis, fracture, rheumatoid arthritis and metabolic diseases.
- Prolonged history of steroid use.
- Resting blood pressure greater than 140/90 mmhg.
- cervical spinal stenosis, diminished sensation and central nervous system involvement,
- previous head or neck surgery or whiplash injury history within the last 6 weeks
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
this study will be conducted to investigate impact of adding jones technique to mulligan therapy in patients with cervicogenic headache
Read the detailed description
Cervicogenic headache (CeH) is a secondary headache attributed to dysfunctions of the cervical spine (international headache society. CGH is a non-throbbing, unilateral, side locked headache that originates in the cervical spine and gradually spreads to the occipital, temporal and orbital areas. It is associated with neck pain or stiffness and is often aggravated by sustained neck postures, repeated neck movements or physical activity. A survey published in 2003 found that strain-counterstrain was the forth most commonly used manipulative technique among providers of osteopathy in the US. The most common explanation for the effects of strain-counterstrain is that it influences aberrant neuromuscular activity mediated by muscle spindles, local circulation and inflammatory reactions. Clinical research into the effects of strain-counterstrain has only begun to emerge in recent years . The Mulligan manoeuvre is one of the best manipulations. Unlike traditional mobilization, which relies solely on the therapist, Mulligan posited that by exerting pressure on the spinous processes in a weight-bearing stance, the facet joints would undergo a synchronized sliding motion in a parallel manner. At the same time, It requires the patient to move actively in order to achieve the perfect therapeutic effect ,The Mulligan maneuver is highly efective in the manipulative treatment of CEH A systematic review have demonstrated the efficacy of the Mulligan maneuvre for CEH on clinical pain scales and cervical range of motion after treatment
- Conditions
- Cervicogenic Headache
- Being tested
- jones and mulligan therapy, mulligan therapy, exercises program
- Keywords
- jones technique, mulligan therapy, cervicogenic headache
- Medical subject headings
- Post-Traumatic Headache
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
jones and mulligan therapyOther
for jones technique in upper trapezius and suboccipital muscles, the participants supine , the therapist used manual palpation to locate the tender area in the UT and sub-ossipital muscles. Once detected, pressure to the tender area was progressively increased . The participant was then repositioned passively to decrease the stress under palpation, resulting in a 70% subjective decrement in pain. That position was maintained for 90 s. eventually, the participant returned to the neutral position slowly and passively. for mulligan SNAGS,The therapist held the patient with his trunk, and wrapped the patient's head lightly with his arm on the patient's side, and placed the ring finger on the trouble spot right above the small vertebral joint. The therapist placed the thenar eminence of his opposite hand on the ring finger, which was touching the lesion site. On the site, the therapist performed gliding in the upward direction of the front pupil (45 degrees) exercises
mulligan therapyOther
mulligan SNAGS,The therapist held the patient with his trunk, and wrapped the patient's head lightly with his arm on the patient's side, and placed the ring finger on the trouble spot right above the small vertebral joint. The therapist placed the thenar eminence of his opposite hand on the ring finger, which was touching the lesion site. On the site, the therapist performed gliding in the upward direction of the front pupil (45 degrees). The hand, which was touching the spinous process, should be relaxed in order not to squeeze too hard. The source of the power of gliding on the joint surface must come from the opposite hand of the patient-contacting hand. Gliding was applied rhythmically (three times per second) and the width of gliding starts from the middle to the end+ exercises
exercises programOther
The exercise program will be in the form of stretching exercises for the sternocleidomastoids (SCM), the scalenes, and upper fibers of trapezius; strengthening isometric exercises for the neck flexors, extensors, lateral flexors, and neck rotators; and postural correction exercises.
| Study group | Role | What they receive |
|---|---|---|
| jones and mulligan therapy | Experimental | thirty patients will receive the Jones technique puls mulligan and exercises programe three times a week for four weeks Receives: Other: jones and mulligan therapy; Other: mulligan therapy; Other: exercises program |
| mulligan therapy | Experimental | thirty patients will receive mulligan therapy and exercise programs three times a week for four weeks Receives: Other: mulligan therapy; Other: exercises program |
| exercises program | Active comparator | thirty patients will receive exercise programs three times a week for four weeks Receives: Other: exercises program |
What is being measured
The primary outcome is the main question the study is designed to answer.
pain intesnity
visual analogue scale will be used to asses pain intensity which patient will be instructed to put point on line from no pain to tolerable pain. The scale consists of a line, usually 100 mm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel .
Measured: up to four weeks
headache disability
The Headache spesific Disability Questionnaire was used to assess headcahe disability. it is a self-administered scale with 9 items that assesses pain intensity, work or school disruptions, and the effect on recreational activities in individuals with headache complaints. Higher scores reflect greater impairment.
Measured: up to four weeks
Secondary outcomes (6)
neck disability
will be measured by Arabic neck disability index. It contains ten category/classes. Each category contains six choices (zero-five).Score from zero to four no disability, from five to 15 this is mild, From 15 to 24 this is moderate, from 25 to 34 this is severe, more than 34 this is a complete disability
Measured: up to four weeks
pressure pain threshold
pressure pain threshold pressure pain threshold will be assessed by commander algometer
Measured: up to four weeks
cervical range of motion
range of motion will be measured by inclinometer CROM. The CROM (deluxe version - Performance Attainment Associates, Roseville, MN, USA) measures the cervical range of motion5- for fexion, extension, lateral fexion, and rotation using separate inclinometers. These inclinometers are attached to a frame similar to that for eyeglasses one in the sagittal plane for fexion - extension, second in the frontal plane for lateral fexion and a third in the horizontal plane for rotation.
Measured: up to four weeks
headache frequency
the number of days the subjects feel headache (headache frequency).
Measured: up to four weeks
medication intake
from the patients' diary in the last week , medications intake will be recorded as follow: 1) not at all; 2) once a week; 3) once every couple of days; 4) once or twice a day; or 5) three or more times a day
Measured: up to four weeks
headache duration
the total hours of headache (headache duration).
Measured: up to four weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jul 2025
- Study start30 Jun 2025 (estimated)
- Primary completion30 Jan 2026 (estimated)
- Study completion30 Jan 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Cervicogenic HeadacheStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- jones and mulligan therapy
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Al Shaymaa Shaaban Abd El Azeim, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07047313
- Sponsor's protocol ID
- P.T.REC/012/005807
- Acronym
- CGH
- Status last verified
- Jun 2025
- First submitted
- 24 Jun 2025
- Last updated
- 2 Jul 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 2 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of Adding Jones Technique to Mulligan Therapy in Patients With Cervicogenic Headache
- ClinicalTrials.gov ID
- NCT07047313
- Acronym / sponsor ID
- CGH / P.T.REC/012/005807
- Conditions
- Cervicogenic Headache
- Keywords
- jones technique, mulligan therapy, cervicogenic headache
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 30 Jun 2025 (estimated)
- Primary completion
- 30 Jan 2026 (estimated)
- Study completion
- 30 Jan 2026 (estimated)
- First posted
- 2 Jul 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
this study will be conducted to investigate impact of adding jones technique to mulligan therapy in patients with cervicogenic headache
Detailed description
Cervicogenic headache (CeH) is a secondary headache attributed to dysfunctions of the cervical spine (international headache society. CGH is a non-throbbing, unilateral, side locked headache that originates in the cervical spine and gradually spreads to the occipital, temporal and orbital areas. It is associated with neck pain or stiffness and is often aggravated by sustained neck postures, repeated neck movements or physical activity. A survey published in 2003 found that strain-counterstrain was the forth most commonly used manipulative technique among providers of osteopathy in the US. The most common explanation for the effects of strain-counterstrain is that it influences aberrant neuromuscular activity mediated by muscle spindles, local circulation and inflammatory reactions. Clinical research into the effects of strain-counterstrain has only begun to emerge in recent years . The Mulligan manoeuvre is one of the best manipulations. Unlike traditional mobilization, which relies solely on the therapist, Mulligan posited that by exerting pressure on the spinous processes in a weight-bearing stance, the facet joints would undergo a synchronized sliding motion in a parallel manner. At the same time, It requires the patient to move actively in order to achieve the perfect therapeutic effect ,The Mulligan maneuver is highly efective in the manipulative treatment of CEH A systematic review have demonstrated the efficacy of the Mulligan maneuvre for CEH on clinical pain scales and cervical range of motion after treatment
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- jones and mulligan therapy
| Arm | Type | Receives |
|---|---|---|
| jones and mulligan therapy | Experimental | Other: jones and mulligan therapy, Other: mulligan therapy, Other: exercises programthirty patients will receive the Jones technique puls mulligan and exercises programe three times a week for four weeks |
| mulligan therapy | Experimental | Other: mulligan therapy, Other: exercises programthirty patients will receive mulligan therapy and exercise programs three times a week for four weeks |
| exercises program | Active comparator | Other: exercises programthirty patients will receive exercise programs three times a week for four weeks |
Who may qualify
- Ages
- 20 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- 20 to 60 years old patient with unilaterally of the head pain
- pain triggered by external pressure over the upper cervical joints (c1-c3)
- pain elicited by the neck movements, and/or sustained awkward positions with reduced neck ROM
- headache intensity pain score of at least 20mm on the Visual analogue scale (VAS)
- headache frequency of at least once a week for at least 3 months
Key exclusion criteria (5 listed)
- Migraine, tension- type headache, tumor, osteoporosis, fracture, rheumatoid arthritis and metabolic diseases.
- Prolonged history of steroid use.
- Resting blood pressure greater than 140/90 mmhg.
- cervical spinal stenosis, diminished sensation and central nervous system involvement,
- previous head or neck surgery or whiplash injury history within the last 6 weeks
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| jones and mulligan therapyfor jones technique in upper trapezius and suboccipital muscles, the participants supine , the therapist used manual palpation to locate the tender area in the UT and sub-ossipital muscles. Once detected, pressure to the tender area was progressively increased . The participant was then repositioned passively to decrease the stress under palpation, resulting in a 70% subjective decrement in pain. That position was maintained for 90 s. eventually, the participant returned to the neutral position slowly and passively. for mulligan SNAGS,The therapist held the patient with his trunk, and wrapped the patient's head lightly with his arm on the patient's side, and placed the ring finger on the trouble spot right above the small vertebral joint. The therapist placed the thenar eminence of his opposite hand on the ring finger, which was touching the lesion site. On the site, the therapist performed gliding in the upward direction of the front pupil (45 degrees) exercises | Other | jones and mulligan therapy |
| mulligan therapymulligan SNAGS,The therapist held the patient with his trunk, and wrapped the patient's head lightly with his arm on the patient's side, and placed the ring finger on the trouble spot right above the small vertebral joint. The therapist placed the thenar eminence of his opposite hand on the ring finger, which was touching the lesion site. On the site, the therapist performed gliding in the upward direction of the front pupil (45 degrees). The hand, which was touching the spinous process, should be relaxed in order not to squeeze too hard. The source of the power of gliding on the joint surface must come from the opposite hand of the patient-contacting hand. Gliding was applied rhythmically (three times per second) and the width of gliding starts from the middle to the end+ exercises | Other | jones and mulligan therapy, mulligan therapy |
| exercises programThe exercise program will be in the form of stretching exercises for the sternocleidomastoids (SCM), the scalenes, and upper fibers of trapezius; strengthening isometric exercises for the neck flexors, extensors, lateral flexors, and neck rotators; and postural correction exercises. | Other | exercises program, jones and mulligan therapy, mulligan therapy |
Primary outcome
pain intesnity
Time frame: up to four weeks
visual analogue scale will be used to asses pain intensity which patient will be instructed to put point on line from no pain to tolerable pain. The scale consists of a line, usually 100 mm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel .
headache disability
Time frame: up to four weeks
The Headache spesific Disability Questionnaire was used to assess headcahe disability. it is a self-administered scale with 9 items that assesses pain intensity, work or school disruptions, and the effect on recreational activities in individuals with headache complaints. Higher scores reflect greater impairment.
6 secondary outcomes
neck disability
Time frame: up to four weeks
pressure pain threshold
Time frame: up to four weeks
cervical range of motion
Time frame: up to four weeks
headache frequency
Time frame: up to four weeks
medication intake
Time frame: up to four weeks
headache duration
Time frame: up to four weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jul 2025.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A study testing jones and mulligan therapy, mulligan therapy and exercises program in people with Cervicogenic Headache, run by Cairo University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 2 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact alshaymaa abd elazeim, phd (01033771553, alshaymaa.shaaban@pt.cu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
pain intesnity (time frame: up to four weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jul 2025.