Headache

Headaches originating from the cervical spine are believed to account for approximately 15-20% of all chronic and recurrent headaches.¹  The International Headache Society (IHS) defines cervicogenic headache as “pain referred from a source in the neck and perceived in one or more regions of the head and/or face².”

 
 

Individuals with cervicogenic headache have been shown to exhibit restricted neck motion, palpable upper cervical joint dysfunction, and impaired muscle performance of the deep neck flexors.³
 

Limited upper cervical spine rotation with the neck flexed has been shown to differentiate individuals suffering from cervicogenic headache from those suffering from migraine headache.⁴

 

 

How can we help?

Based on the available current best evidence, the combination of exercise and manual physical therapy has been shown to be beneficial in reducing symptoms of headaches.  Jull et al.⁵ showed that a physical therapy program that combined manipulative interventions with endurance training for deep neck flexor endurance resulted in significantly reduced frequency, intensity, and duration of headaches.  These improvements were maintained at twelve month follow-up.  Hall et al. ⁶ showed that regular performance of a patient self-mobilization exercise resulted in significant improvements in headache symptoms.  These benefits were also maintained at twelve months.

 

Effective Interventions: 

·         Deep neck flexor endurance training

·         Self-mobilization

·         Postural education

·         Manual physical therapy



References:

Nilsson N.  The prevalence of cervicogenic headaches in a random population sample of 20-59 year olds.  Spine 1995;20:1884-1888.

The International Classification of Headache Disorders:  2^nd Edition.  Cephalgia 2004.24:9-160.

Jull et al.  Cervical musculoskeletal impairment in frequent intermittent headache, Part 1:  subjects with single headaches.  Cephalgia  2007.27:793-802.

Zito G, Jull G.  Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Manual Therapy 2006;11:118-130.

Jull et al.  A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache.  Spine 2002;27(12):1835-1843.

Hall et al.  Efficacy of a C1-C2 self-sustained natural apophyseal glide in the management of cervicogenic headache.  JOSPT  2007;37(3):100-107.

American Gastroenterological Association (2005, January 16). Study Shows Long-term Use Of NSAIDs Causes Severe Intestinal Damage.ScienceDaily. Retrieved January 31, 2011, from http://www.sciencedaily.com­/releases/2005/01/050111123706.htm

Hall  T, Briffa K.  Reliability of manual examination and frequency of symptomatic cervical motionsegment dysfunction in cervicogenic headache.  Man Ther 2010;15:542-546.

Gadotti I, Olivo S, Magee D.  Cervical musculoskeletal impairments in cervicogenic headache: a systematic review and a meta-analysis.  Physical Therapy Reviews  2008;13(3):149-166.