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EP246 Prolotherapy in the treatment of cervicogenic headache
  1. Ioanna-Io Zagkli1,
  2. Zak Raphael2,
  3. Dimitrios Zagklis3 and
  4. Kassiani Theodoraki4
  1. 1Department of Neurology, Hellenic Red Cross Hospital, Athens, Greece, Athens, Greece
  2. 2Department of Economics, National and Kapodistrian University of Athens, Greece, Athens, Greece
  3. 3Private Practice, Clinic for Comprehensive Treatment of Chronic Pain and Headache Disorders, Athens, Greece, Athens, Greece
  4. 4Department of Anesthesiology, Aretaieion University Hospital, National and Kapodistrian University of Athens, Greece, Athens, Greece


Background and Aims In cervicogenic headache the pain originates from the cervical structures. The goal of this study was to investigate whether there is a better outcome by treating cervicogenic headache with paracetamol and ibuprofen versus the injection of hypertonic dextrose solution (prolotherapy)

Methods Forty patients suffering from cervicogenic headache were randomized to treatment by either paracetamol and ibuprofen or by prolotherapy. Patients subjected to prolotherapy were injected in 10 symmetrical points of the neck and upper back. The frequency of headache per week, the duration of headache in hours and the pain intensity with the VAS score 0-10 were assessed

Abstract EP246 Figure 1

Prolotherapy injection points

Abstract EP246 Figure 2

Differences between first and third assessment in the prolotherapy group

Results Prolotherapy showed higher rates of successful treatment of cervicogenic headache, with statistically significant differences between the first and the last assessment in all aspects of headache. Reduction by 81.25% of the frequency of attacks per week, reduction by 89.75% of the duration in hours and reduction by 77.84% of the headache intensity were demonstrated between the first and the last visit. Changes were less spectacular in the conventional treatment group: treatment with conventional pain killers resulted in 6.25% decrease in the frequency of attacks per week, in 44.61% decrease in the duration of pain in hours and in 26.81% decrease in the headache intensity between the first and last visit. Differences between groups were statistically significant

Conclusions In cases of cervicogenic headache, patients treated with prolotherapy have significant improvement. It appears that prolotherapy, by strengthening the ligaments and tendons of the cervical area can target the trigger points that cause the headache

  • cervicogenic headache
  • prolotherapy
  • hypertonic saline
  • injection
  • chronic pain

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