Physical Therapy and Manual Therapy for Prevention and Rehabilitation of Cervical Myofascial Pain and Headache

The purpose of this study is to assess the effectiveness of physical therapy and manual therapy in the treatment and prevention of cervical myofascial pain and headache caused by spinal malposition in smart phone users (abusers). A total of 69 patients with headaches and cervical myofascial pain were under our observation. The patients ranged in age from 19 to 49 years old, had cervical spine posture (position) changes, but no major cervical pathology. For at least six months, all patients used a mobile device in their regular activities (at least two hours per day). Before, during, and after treatment, as well as one month following the conclusion of the rehabilitation, functional evaluation was carried out. We used a comprehensive physical therapy programme on all patients, which included post-isometric relaxation (PIR) for the sterno-cleido-mastoideus and upper trapezius muscles, massages, and analytic exercises for paravertebral muscles, as well as encouraging patients to actively engage in the prevention process (education in principles of back-school, self-massage, auto-PIR). In all patients, we noticed improvements in the cervical spine's static position, less paravertebral muscular spasm, a decrease in the sensitivity of the trigger and tender points, and an increase in the cervical area of the spine's range of active motion. The second group (with manual treatment) produced the most significant results throughout the recovery phase, but a month later, there are no longer any statistically significant differences between the two groups. Physical therapy and manual therapy techniques are particularly helpful for the prevention and recovery phases of headache and cervical myofascial pain. Active (analytic) exercises, PIR and stretching techniques, tractions and mobilizations, patient education, and (in some circumstances) manipulations are all part of the treatment plan. We believe that each physical therapist and medical practitioner who specialises in physical and rehabilitation medicine must modify the general algorithm to meet the demands of the specific patient.