Comparative Effects of Post Isometric Relaxation and Reciprocal Inhibition in Individuals With Cervicogenic Headache.

This study aims to compare the effects of Post Isometric Relaxation (PIR) and Reciprocal Inhibition (RI) in individuals with cervicogenic headache, a secondary headache originating from dysfunction of the cervical spine, particularly the upper cervical segments. Cervicogenic headache is characterized by unilateral head and neck pain, restricted cervical mobility, muscle tightness, and functional limitations that negatively affect daily activities and quality of life. The study will employ a randomized controlled trial involving 46 participants aged 18-45 years who meet the inclusion criteria. Participants will be randomly allocated into two groups: Group A will receive Post Isometric Relaxation, while Group B will receive Reciprocal Inhibition. Both groups will also receive a standard physiotherapy protocol consisting of hot packs, cervical isometric exercises, and C1-C2 Sustained Natural Apophyseal Glides (SNAGs), administered three times per week for four weeks. Pain intensity, functional disability, and cervical range of motion will be assessed before and after the intervention using the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), and goniometric measurements, respectively. By comparing these two muscle energy techniques, the study seeks to determine which intervention is more effective in reducing pain, improving cervical mobility, and enhancing functional outcomes, thereby providing evidence to support clinical decision-making and optimize physiotherapy management for individuals with cervicogenic headache.

Inclusion criteria * Patients are diagnosed according to ICH criteria. * Age 18-45 years. * Both Genders (Male and Female). * Headache \> 3 months. * Unilateral neck pain and associated headache. * Headache is precipitated by neck movements or sustained positions. * Restricted upper cervical segmental mobility. * Positive cervical flexion rotation test, restriction greater than 10°. Exclusion criteria * History of head and neck trauma. * Neoplasm. * Cognitive disability. * Inherited disorders such as scoliosis and torticollis. * Other chronic pain syndrome (i.e.: fibromyalgia, systematic inflammatory disease). * History of recent surgery of cervical spine.