Comparative Effects of Fascial Manipulation Technique Versus Joint Cavitation on the Atlanto-Occipital Joint in Patients with Cervicogenic Headache

Background: Cervicogenic headache (CEH) is a secondary headache disorder originating from musculoskeletal dysfunctions of the cervical spine, particularly the atlanto-occipital (AO) joint. Office workers are highly susceptible due to prolonged sitting and poor posture. While manual therapy interventions are commonly used, comparative effectiveness between fascial manipulation technique (FMT) and joint cavitation (JC) remains underexplored. Objective: To compare the effects of FMT and JC on pain, cervical range of motion (ROM), headache impact, and neck disability in office workers with CEH. Methods: A single-blind randomized controlled trial was conducted with 36 office workers (aged 25–40 years) diagnosed with CEH. Participants were randomly allocated to Group A (FMT, n=18) or Group B (JC, n=18). Interventions were administered twice weekly for six weeks. Outcomes included Numeric Pain Rating Scale (NPRS), Cervical ROM (CROM device), Headache Impact Test (HIT-6), and Neck Disability Index (NDI), assessed at baseline and after six weeks. Non-parametric tests (Wilcoxon Signed Rank and Mann–Whitney U) were used for analysis. Results: Both groups showed significant within-group improvements (p<0.05). However, between-group comparisons revealed that FMT produced statistically superior outcomes in pain reduction (NPRS-Head p=0.014; NPRS-Neck p=0.014), cervical ROM (flexion p=0.005; extension p=0.010; lateral flexion p=0.041), headache impact (HIT-6 p=0.023), and neck disability (NDI p=0.004). Conclusion: Fascial Manipulation Technique is more effective than Joint Cavitation in improving pain, mobility, headache impact, and functional disability in patients with cervicogenic headache. These findings advocate for the integration of fascial-based approaches in CEH management protocols, particularly for sedentary populations. Keywords: Cervicogenic headache, Atlanto-occipital joint, Fascial manipulation, Joint cavitation, Manual therapy, Neck disability, Office workers, Randomized controlled trial.