Cervicogenic Headaches

Cervicogenic Headaches and Manual Physical Therapy

What's Cervicogenic Pain?

A Cervicogenic headache is pain perceived in the head but referred from a primary source in the cervical spine. These headaches are common and recurring. Distinguishing criteria of headaches arising from musculoskeletal dysfunction (Zito et al, 2006) include:

• Decreased range of cervical flexion/extension
• Higher incidence of painful upper cervical joint dysfunction
• Muscle tightness

Diagnostic Criteria

The two most important diagnostic criteria for Cervicogenic headaches (Childs et al, 2004) are:

• Pattern of symptoms that start in the neck and progress to the fronto-ocular area
• Unilateral headaches (sensitivity, 100% for each finding)

Physical Therapy is found to be effective as the first line of management to reduce the symptoms of Cervicogenic headache and maintain this relief in long term.

Cervicogenic Headache Referral Criteria

• Unilateral or unilateral dominant side-consistent headache associated with neck pain
• Headache pain triggered by neck postures or movement
• Joint tenderness that elicits headache pain in at least one of the upper three cervical joints as detected by manual palpation
• Headache frequency of at least one week (acute or chronic)
• May also include ipsilateral shoulder and arm pain of a non-radicular nature

Proposed Interventions:

Based on impairments found in Cervicogenic headache cases

• Cervical and/or thoracic spine manipulation/mobilization
• Soft tissue mobilization
• Strengthening the upper quarter
• Reeducation of muscle control in the cervico-scapular region to promote efficient posture
• Postural/ergonomic education
• IMS/TDN
  

Full documentation and references on Cervicogcnic Headaches and Manual Physical Therapy is available by calling (303) 252-9400.