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Not yet recruitingNCT07724639Updated Jul 24, 2026

Effects of Graston Versus Myofascial Release Technique in Patients With Cervicogenic Headache

An interventional study of Graston technique and Myofascial Release Therapy in Cervicogenic Headache, sponsored by Riphah International University. Not yet recruiting. Open to participants aged 18 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-07-24.

Sponsored by Riphah International University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
48
Allocation
Randomized
Ages
18 Years to 40 Years
Sex
All
01

Study summary

Cervicogenic Headache (CGH) is a painful condition that has pronounced impacts on quality and activity of daily lives. It is often associated with decreased mobility, muscular tightness, and postural deviations. When neck muscles become tight, weak, or irritated, they change the way the neck moves and put pressure on nearby joints and nerves. This pressure delivers pain signals to the head, causing a Cervicogenic headache.

Read the detailed description

The aim of this study is to compare the effects of the Graston Technique and Myofascial Release in reducing pain, improving cervical range of motion, and decreasing functional disability in patients with Cervicogenic headache.

This study will be a randomized control trial and will be take place at Sehat Medical Complex, lake city branch, Lahore. Non-probability convenience sampling will be used to collect data. Sample size of ( ) subjects with age group between 18-40 years will be taken. Data will be collected from the patients having present complaint of Cervicogenic headache. Outcome measures will be assessed using numeric pain rating scale (NPRS) for pain, Neck Disability Index (NDI) to measure neck related disability, Headache Disability Index (HDI) to assess the impact of headaches on daily activities and emotional well-being and Goniometer for assessing range of motions. An informed consent will be taken and subjects will be selected on basis of inclusion and exclusion criteria. They will be divided into two groups by random number generator. One group will receive Graston technique and other myofascial release as a treatment while both groups will be receiving conventional treatment alongside. Outcome measures will be measured at baseline and after 4 weeks. Data analysis will be done by SPSS version 21.

02

Conditions studied

  • Cervicogenic Headache

Keywords

  • Cervicogenic Headache, Graston Technique, Neck Disability Index, Numeric Pain Rating Scale, Myofascial Release Therapy, Range of Motion
03

In context

Post-Traumatic Headache

192 studies on the registry are indexed under Post-Traumatic Headache; 54 are open to participants now.

This study's planned enrollment of 48 is close to the median of 44 across 169 interventional studies indexed under Post-Traumatic Headache.

Browse Post-Traumatic Headache studies →

Lead sponsor

Riphah International University is the lead sponsor of 2,193 studies on the registry; 650 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Males and females between age 18-40 years [A30.1]of age with Cervicogenic Headache
  • Diagnosed with Cervicogenic headache according to ICHD-3 criteria (3)
  • Presence of active myofascial trigger points in the SCM and upper trapezius and subocvcipital levator scapuli (confirmed [A31.1]via palpation and referred pain) simens [A32.1]criteria
  • Positive Cervical Flexion Rotation Test

Exclusion criteria

Exclusion Criteria:

  • Any history of cervical trauma, fracture, or recent surgery.
  • Diagnosis of migraine, tension-type headache, or cluster headache (9).
  • Any cervical spine pathology e.g. cervical myelopathies and arthropathies.
  • Pregnant or lactating women.
  • Skin conditions or open wounds that contraindicate use of Graston tools e.g. open wounds, skin infections and burns etc.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
48 participants (estimated)

Study arms

  • Experimental
    Group A: Graston technique

    Patients will receive the Graston technique with conventional treatment

    Other: Graston technique

  • Active comparator
    Group B: Myofascial release therapy

    Patients will receive Myofascial release therapy with conventional treatment.

    Other: Myofascial Release Therapy

Interventions

  • OtherGraston technique

    * Applied to: Sternocleidomastoid, Upper trapezius, Levator scapulae, Suboccipitals and cervical paraspinals. * Duration: 5-7 minutes per session, depending on patient tolerance and therapist assessment. * Frequency: 2-3 sessions per week, for 4 weeks

  • OtherMyofascial Release Therapy

    * Manual release applied to same regions as above using sustained pressure and fascial stretch. * Duration: 7-10 minutes per session. * Frequency: 2-3 sessions per week, for 4 weeks.

06

What researchers measure

Primary outcomes

  1. Neck Disability Index (NDI)

    Time frame: upto 4 weeks

  2. Numeric Pain Rating Scale (NPRS)

    Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain".

    Time frame: upto 4 weeks

Secondary outcomes

  1. Universal Goniometer (UG)

    The range of motion will be measured using universal goniometer that has an inter-rater reliability (ICC2, 2 = 0.79 to 0.92) for cervical region

    Time frame: upto 4 weeks

  2. Global Rating of Change (GROC) scale

    Global Rating of Change (GROC) scale

    Time frame: upto 4 weeks

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. Lancet Neurol. 2009 Oct;8(10):959-68. doi: 10.1016/S1474-4422(09)70209-1. PubMed 19747657 ↗
  • Hall TM, Briffa K, Hopper D, Robinson K. Comparative analysis and diagnostic accuracy of the cervical flexion-rotation test. J Headache Pain. 2010 Oct;11(5):391-7. doi: 10.1007/s10194-010-0222-3. Epub 2010 May 28. PubMed 20508964 ↗
  • Nambi G, Alghadier M, Pakkir Mohamed SH, Vellaiyan A, Ebrahim EE, Sobeh DE, Kashoo FZ, Albarakati AJA, Alshahrani NA, Eswaramoorthi V. Combined and isolated effects of workstation ergonomics and physiotherapy in improving cervicogenic headache and work ability in office workers: a single-blinded, randomized controlled study. Front Public Health. 2024 Nov 28;12:1438591. doi: 10.3389/fpubh.2024.1438591. eCollection 2024. PubMed 39697289 ↗
  • Lerner-Lentz A, O'Halloran B, Donaldson M, Cleland JA. Pragmatic application of manipulation versus mobilization to the upper segments of the cervical spine plus exercise for treatment of cervicogenic headache: a randomized clinical trial. J Man Manip Ther. 2021 Oct;29(5):267-275. doi: 10.1080/10669817.2020.1834322. Epub 2020 Nov 5. PubMed 33148134 ↗
  • Verma S, Tripathi M, Chandra PS. Cervicogenic Headache: Current Perspectives. Neurol India. 2021 Mar-Apr;69(Supplement):S194-S198. doi: 10.4103/0028-3886.315992. PubMed 34003165 ↗
  • Mingels S, Granitzer M, Jull G, Dankaerts W. The occurrence of cervicogenic headache: A mapping review. Musculoskelet Sci Pract. 2025 Jun;77:103290. doi: 10.1016/j.msksp.2025.103290. Epub 2025 Feb 20. PubMed 40031141 ↗
  • Robinson CL, Christensen RH, Al-Khazali HM, Amin FM, Yang A, Lipton RB, Ashina S. Prevalence and relative frequency of cervicogenic headache in population- and clinic-based studies: A systematic review and meta-analysis. Cephalalgia. 2025 Mar;45(3):3331024251322446. doi: 10.1177/03331024251322446. Epub 2025 Mar 17. PubMed 40094720 ↗
  • Olesen J. International Classification of Headache Disorders. Lancet Neurol. 2018 May;17(5):396-397. doi: 10.1016/S1474-4422(18)30085-1. Epub 2018 Mar 14. No abstract available. PubMed 29550365 ↗
  • Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. doi: 10.1177/0333102417738202. No abstract available. PubMed 29368949 ↗
  • Al Khalili Y, Ly NK, Murphy PB. Cervicogenic Headache. 2022 Oct 3. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK507862/ PubMed 29939639 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Jul 2026; primary completion for Dec 2026, 5 months later.

Of 89 non-industry interventional studies with no phase under Post-Traumatic Headache, half reached primary completion within 11 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 26. This study's planned 5 months is below that.

Counting every sponsor, half of 90 studies reached it within 12 months; a quarter within 5 and three quarters within 26.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 21, 2026
First posted
Jul 24, 2026
StartEst.
Jul 2026
Primary completionEst.
Dec 15, 2026
CompletionEst.
Dec 30, 2026
Last update
Jul 24, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07724639
Responsible party
Sponsor
First posted
Jul 24, 2026
Start date
Jul 2026 (estimated)
Primary completion
Dec 15, 2026 (estimated)
Completion
Dec 30, 2026 (estimated)
Last update
Jul 24, 2026

Study contacts

Sumrod Akram
Contact
samrood.akram@riphah.edu.pk
03324806143
Sofia Rahim, MSPT*
principal investigator · Riphah International University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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