title: Further evidence of the positive effects of an educational and physical program on headache, neck and shoulder pain in a working community.
abstract: In a controlled trial to evaluate the effectiveness of a simple educational and physical program administered to a large cohort of public servants, we previously found that 6 months following treatment the monthly frequency of headache and neck and shoulder pain and drug intake was reduced by 40% in the experimental compared with controls. These results were stable at a 12-month follow up. The program consists of brief shoulder and neck exercises to be performed several times a day, a relaxation exercise, and instructions on how to reduce parafunction and hyperfunction of the craniofacial and neck muscles during the day. The purpose of this work was to investigate whether the data previously obtained could be confirmed also in the group of 192 subjects that served as controls in first phase of the study and received the intervention in the second phase of the study. The primary endpoint was the change in frequency of headache and neck and shoulder pain expressed as the number of days per month with pain, and as the proportion of subjects with a ≥ 50% reduction of frequency (responder rate) at the last 2 months of the 6-month intervention period compared to the 2 months preceding the intervention (baseline). The number of days of analgesic drug consumption was also recorded. Days per month with headache at the baseline and at the end of intervention period were 6.40 and 4.58 (mean change -1.81, p < 0.0001), respectively; days with neck and shoulder pain were 7.48 and 6.18 (mean change -1.30, p = 0.0179); days of analgesic consumption were 1.67 and 1.17 (mean change -0.50, p = 0.0222). The responder rate was 42.3% for headache, 42% for neck and shoulder pain and 58.3% for drug consumption. In conclusion, this study adds further evidence on the efficacy of our program and its high acceptability in a large, unselected, working population.
authors.affiliation: Headache and Facial Pain Unit, Department of Clinical Pathophysiology, University of Turin, Corso Dogliotti 14, Turin, Italy. franco.mongini@unito.it
authors.forename: Franco
authors.initials: F
authors.lastname: Mongini
authors.forename: Andrea
authors.initials: A
authors.lastname: Evangelista
authors.forename: Eugenia
authors.initials: E
authors.lastname: Rota
authors.forename: Luca
authors.initials: L
authors.lastname: Ferrero
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ugolini
authors.forename: Chantal
authors.initials: C
authors.lastname: Milani
authors.forename: Manuela
authors.initials: M
authors.lastname: Ceccarelli
authors.forename: Laura
authors.initials: L
authors.lastname: Joffrain
authors.forename: Giovannino
authors.initials: G
authors.lastname: Ciccone
authors.forename: Claudia
authors.initials: C
authors.lastname: Galassi
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003150:Community Health Workers; D004185:Disability Evaluation; D005081:Exercise Therapy; D005260:Female; D006261:Headache / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation*; D010147:Pain Measurement; D012189:Retrospective Studies; D020069:Shoulder Pain / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome