Background and Goal of Study: Headaches of cervicogenic location are 11.3-40% of all presenting symptoms in primary healthcare structure. [1] Cervicogenic headaches’ (CH) prevalence in population is 1-12%. [2]

Materials and Methods: Double blinded placebo controlled study, approved by the Institutional Review Board, involved 60 amateur athletes with CH. Patients, who attended the clinic in Sept.2016–Aug.2017, were divided into three groups (20patients each) by the sealed envelope method. All patients received venlafaxitine 75mg/day and tizanidine 4mg/day during 12 and 4 weeks respectively. Mindfulness group was additionally educated with mindfulness meditation techniques (weekly 2-hour group sessions with following daily outside preparation and individual session for every participant), invasive pain management techniques group received 0.5% lidocaine injections in trapezius muscle trigger points (10injections with 2day intervals). The treatment effectiveness was evaluated prior to, 3 and 12 months after the treatment by pain attacks frequency and severity with the Visual Analog Scale (VAS) and Pain Catastrophizing Scale (PCS).

Results and Discussion: The mean age was 38.5±9.1, 41.5±8.4 and 42±7.6 in the mindfulness, injections and control group, respectively. Most of respondents were females (65%, 74%, 79% respectively). The pretreatment VAS score was 6.2±1.1, 5.9±1.5 and 4.9±1.8 points and pain attack frequency – 19.2±5.4, 16.6±4.9 and 22.1±7.2 per month, total PCS score – 21.1±9.1, 19.4±8.7 and 20.7±6.9 points in mindfulness, injections and control group, respectively. After the 3-months treatment, VAS score was significantly lower in the injections group (1.1±0.3) than in mindfulness (2.7±0.2) and control groups (2.5±0.8; p<0.05), as well as total PCS score (10.2±8.1; 15.5±9.2; 16.3±10.6 respectively, p<0.05). But after the 12-months treatment pain intensity was the lowest in the mindfulness group (1.2±0.4) comparing to injections (2.7±0.4) and control (3.1±0.6, p<0.05) groups, as well as total PCS score (7.5±6.1; 15.1±9.6; 14.8±7.4 respectively, p<0.05).

Conclusion(s): Mindfulness therapy can significantly improve pain states in patients with CH.

References:
1. Osipova V. Cephalalgia.2016;36(S1):72.
2. Zagorulko O. Rus J Pain 2017;1(52):90-91.

05 / The efficacy of mindfulness therapy and in comparison with invasive pain management techniques in cervicogenic headaches treatment