Spinal Manipulation With Perineural Electrical Dry Needling for Cervicogenic Headache

Physical therapists who see patients with headache and neck pain in outpatient orthopedic settings, along with physical therapist assistants who deliver treatment under the direction of a physical therapist and want to follow the evidence behind the interventions they are asked to carry out.

Licensed physical therapists and physical therapist assistants in outpatient orthopedic, sports, and manual therapy practice. The material also suits clinicians in headache-focused or interdisciplinary pain programs who want a clear account of what this trial did and did not show.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports on a single open-access clinical study. Every finding, number, and conclusion presented here comes from that paper. No outside data, no other trials, and no clinical recommendations of our own have been added.

Dunning J, Butts R, Zacharko N, Fandry K, Young I, Wheeler K, Day J, Fernández-de-las-Peñas C. Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multicenter randomized clinical trial. The Spine Journal. 2020. Open access under the CC BY-NC-ND license. Trial registration: ClinicalTrials.gov NCT02373605.

A note on the authors

The paper states that three of the authors are faculty within the fellowship program that teaches the manipulation, mobilization, dry needling, and exercise techniques used in the trial, and that they teach postgraduate courses in those methods. The remaining authors declared no conflicts of interest, and the paper states that no author received funding for the study. Readers weighing the strength of the evidence may want to hold that disclosure alongside the results.

Up next: the audio lesson, which walks through the trial from enrollment to the three-month follow-up.

After completing this course, you will be able to:

1. Describe who was enrolled in this multicenter randomized trial, what the two treatment arms consisted of, and how long patients were followed.
2. State what the trial found for headache intensity, headache frequency, headache duration, neck-related disability, medication use, and patient-rated improvement at the three-month follow-up.
3. Explain the limitations the authors identified and the boundaries they placed on how far these findings can be carried into other protocols and populations.

1. Start Here: How This Course Works
2. Podcast: Manipulation and Electrical Dry Needling for Cervicogenic Headache (about nine minutes)
3. The Question Behind the Trial: Cervicogenic Headache and Its Usual Care
4. Who Was Enrolled and How the Two Treatment Arms Were Delivered
5. What Changed at One Week, Four Weeks, and Three Months
6. Side Effects, Study Limits, and What the Trial Cannot Answer
7. Reading These Results Into Everyday Outpatient Practice
8. Key Takeaways
9. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course reports on a single open-access clinical study. Every finding, number, and conclusion presented here comes from that paper. No outside data, no other trials, and no clinical recommendations of our own have been added.
2. Dunning J, Butts R, Zacharko N, Fandry K, Young I, Wheeler K, Day J, Fernández-de-las-Peñas C. Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multicenter randomized clinical trial. The Spine Journal. 2020. Open access under the CC BY-NC-ND license. Trial registration: ClinicalTrials.gov NCT02373605.
3. A note on the authors
4. The paper states that three of the authors are faculty within the fellowship program that teaches the manipulation, mobilization, dry needling, and exercise techniques used in the trial, and that they teach postgraduate courses in those methods. The remaining authors declared no conflicts of interest, and the paper states that no author received funding for the study. Readers weighing the strength of the evidence may want to hold that disclosure alongside the results.
5. Up next: the audio lesson, which walks through the trial from enrollment to the three-month follow-up.