Efficacy of an instruction program on headache and face, neck and shoulder pain in a working community : a longitudinal controlled study

Aims Our main purpose was to examine the effect of an instruction program on frequency of headache and face, neck and shoulder pain in a working community. Methods. 343 employees of the city of Turin whose working activity involves public contact (registry and tax office) were distributed in two groups: study group (n=167) and controls (n=176). In all subjects data were taken of headache, and facial, neck and shoulder pain, if present. They were then given a diary on which to record, on a daily basis, frequency, severity and duration of the headache and facial, neck and shoulder pain episodes, from March to October 2005. At month 3 an instruction program was administered to the study group: it consisted of brief shoulder an neck exercises to be performed several times a day, a relaxation exercise and instructions of how to reduce hyperfunction of the craniofacial and cervical muscles during the day. Both groups kept the diary for further six months (months 3–8). For each subject, the difference between the frequency of symptoms at months 7–8 and at months 1–2 was calculated, and the mean differences between the two groups were compared (Student t test). Results The monthly frequency of headache significantly decreased over time in the study group compared to controls (from 5.9 to 3.5 vs 6.5 to 6.4, p<0.000); the same pattern was observed for the frequency of facial pain (p=0.03) and neck and shoulder pain (p<0.000). Such significant decrease was confirmed in a multiple regression analysis adjusted by sex and age. Conclusions It is concluded that the administration of a simple instruction program can significantly reduce the prevalence of headache and facial and cervical pain in a working community.