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Cervicogenic headache (CEH) is a chronic, hemicranial pain syndrome in which the sensation of pain originates in the cervical spine or soft tissues of the neck and is referred to the head. Cervicogenic headache is a relatively common but often overlooked disorder. There is sufficient evidence to support this category and the existing diagnostic criteria are adequate. The purpose of this case report was to describe an intervention approach consisting of release and muscle energy techniques for an individual with cervicogenic headache. Clinical examination revealed myofacial trigger points in trapezius, sternocliedomastoid and upper cervical spine erectors. Visual analogue scale (VAS) identified severe pain. Range of flexion and rotation was reduced. Complete pain relief was seen following three times treatment sessions. The results indicating definite diagnosis and appropriate treatment of cervicogenic headache.

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Background and Objective: Myofascial pain syndrome is one of the painful conditions of the musculoskeletal system. There is controversy about the effectiveness of treatment strategy. This study was done to compare the effects of diclofenac phonophoresis with ergonomic instructions on neck and shoulder pain and disability in women with myofascial trigger points in trapezius muscle. Materials and Methods: This clinical trial study was conducted on thirty female students with trigger points in trapezius muscle in Razmejo-Moghadam Physiotherapy Clinic, Zahedan University of Medical Sciences, Iran during 2009. Patients were randomly assigned to one of three equal groups: diclofenac phonophoresis, ergonomic instructions, and control groups. In phonophoresis group, after applying diclofenac gel, ultrasound with frequency of 1 MHz, continuous mode, intensity 1.5 W/cm2, and duration 4.5 min was used. Ergonomic group received instructions in order to maintain appropriate posture during activity of daily life. Control group received ultrasound without output. A 12 session treatment program, during 4 weeks, 3 sessions per week was performed. Neck pain was assessed before and after intervention with Northwick Park Neck Pain Questionnaire and shoulder pain and disability with Shoulder Pain and Disability Index. Data were analyzed using SPSS-17, Kolmogorov-Smirnov, paired t-test, One-way ANOVA and Tukey tests. Results: Neck pain score decreased from 18±3.5 to 7.6±4.4 in phonophoresis group and from 17.8±3.5 to 10.5±3.4 in ergonomic group (P<0.05). Also, shoulder pain and disability score decreased from 106.2±28.1 to 36.76±30.7 in phonophoresis group and from 103.3±22.9 to 26.2±12.3 in ergonomic group (P<0.05). There was no significant difference between post and pretreatment results in control group. After treatment, there was no significant difference between two treatment groups regarding neck, shoulder pain and disability. However, after treatment there was significant difference between two treatment groups and control group regarding pain (P<0.05). Conclusion: This study showed that diclofenac phonophoresis and ergonomic instructions are effective in decreasing neck and shoulder pain and disability in patients with myofascial trigger points in trapezius muscle. None of both treatment strategy was superior to other.

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Background and Objective: The trigger point is the irritable point associated with a tight band of skeletal muscle which is painful against stress and strain. The real goal in treating trigger points is to achieve a degree of pain relief so that the sufferer can return to his usual activities and functions in spite of some pain. This study was carried out to compare of two methods of sports massage and cold stretch on the threshold of pain in passive trigger points in shoulder girdle muscles of the female volleyball players.
Methods: In this quasi-experimental study, 32 females national volleyball palyer who has a latent trigger point in the shoulder girdle region were non-randomly divided into to three groups of sports massage (n=11), stretching along the cold (n=11) and control (n=10) groups. Threshold of pain test was carried out in two steps, prior and immediately after sports massage and stretching along the cold.
Results: The mean of pain threshold prior and immediately after the study in control group was 38.84±11.348 and 35.16±9.311, respectively. The mean of pain threshold prior and immediately after the study in sports massage group was 39.40±9.88 and 43.54±9.63, respectively. This differernce was not significant. The mean of pain threshold prior and immediately after the study in stretching along the cold group was 39.22±10.57 and 41.10±10.95, respectively. This differernce was not significant.
Conclusion: Sports massage and stretching along the cold did not significant effect on the threshold of pain in passive trigger points in shoulder girdle muscles of the female volleyball players.