Physical Profile of Cervicogenic Headache: Comparison With Neck Pain and Healthy Controls

August 20, 2026 updated by: fatih bali, Istanbul Medipol University Hospital

A Multidimensional Physical Profile of Cervicogenic Headache: A Cross-Sectional Comparison With Nonspecific Neck Pain and Healthy Controls

The goal of this observational study is to compare physical findings across three adult groups. Cervicogenic headache (CGH) is a headache linked to a problem in the neck. Neck pain may affect posture, muscle function, grip strength, and sensitivity to pressure. Researchers do not know whether CGH has a distinct pattern of these findings.

The main questions are:

Do posture, grip strength, muscle stiffness, elasticity, and pressure sensitivity differ among the groups?
Are any differences more closely associated with CGH than with neck pain?

Researchers will compare adults ages 25 through 60. One group will include people with CGH lasting at least three months. Another group will include people with neck pain lasting at least six months. People in the neck pain group will have no headaches. Healthy participants will have no neck pain or headaches.

Researchers will not provide treatment or change participants' usual care. Each participant will complete one study visit lasting about 15 minutes. Participants will:

Answer short questions about their health and pain
Stand while researchers measure their head and neck posture
Squeeze a device that measures grip strength
Complete brief tests of neck muscle stiffness and elasticity
Tell researchers when applied pressure first becomes painful

Researchers will compare results across the three groups. The findings may guide future CGH assessment and treatment research.

Study Overview

Status

Recruiting

Conditions

Study Type

Observational

Enrollment (Estimated)

135

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Name: Fatih Bali, PhD.
Phone Number: +905323937689
Email: fatihbali@hotmail.com

Study Locations

Turkey (Türkiye)
- Sefaköy
  - Istanbul, Sefaköy, Turkey (Türkiye), 34433
    - Recruiting
    - Medipol Sefaköy Üniversite Hastanesi
    - Contact:
      
      Fatih Bali, PhD.
      
      Phone Number: +905323937689
      
      Email: fatihbali@hotmail.com
    - Contact:
      
      Email: fatihbali@hotmail.com

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study population consists of adults aged 25-60 years recruited at the study site in Istanbul, Türkiye. Participants are classified into three groups according to predefined clinical criteria. The cervicogenic headache group includes individuals diagnosed by a physician according to the International Classification of Headache Disorders, 3rd edition. The chronic nonspecific neck pain group includes individuals with neck pain lasting at least 6 months and no headache. The healthy control group includes individuals without neck pain or headache. Participants receive no study intervention and complete one questionnaire-based and instrument-based assessment session.

Description

Inclusion Criteria:
Aged 25 to 60 years
Able to provide written informed consent
Meeting the criteria for one of the following groups:
Cervicogenic headache: physician diagnosis according to the International Classification of Headache Disorders, 3rd edition, with symptoms lasting at least 3 months
Chronic nonspecific neck pain: neck pain lasting at least 6 months without headache
Healthy control: no neck pain or headache

Exclusion Criteria:

Receipt of physiotherapy for headache or neck pain during the previous 6 months
Diagnosis of a headache disorder other than cervicogenic headache, including migraine or tension-type headache, or a diagnosis of trigeminal neuralgia
History of cervical spine surgery or significant cervical trauma
Current or previous diagnosis of a tumor or cancer
Serious cardiovascular, cerebrovascular, hematological, metabolic, neurological, or psychiatric disorder
Rheumatoid arthritis
Congenital cervical abnormality
Cervical spondylolisthesis or cervical instability
Active infection
Temporomandibular joint dysfunction
Dizziness or visual disturbance accompanying headache
Any clinical red flag suggesting serious cervical pathology
Pregnancy or breastfeeding
Upper-extremity injury, surgery, or another condition affecting handgrip strength
Serious musculoskeletal disorder affecting cervical posture or muscle measurements
Inability to complete the questionnaire-based or instrument-based assessments

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Number of groups / cohorts

Cohorts and Interventions

Group / Cohort
Cervicogenic Headache Group Adults aged 25-60 years with cervicogenic headache diagnosed by a physician according to the International Classification of Headache Disorders, 3rd edition (ICHD-3), and symptoms lasting at least 3 months. Participants undergo one questionnaire-based and instrument-based assessment session. No intervention is assigned.
Chronic Nonspescific Neck Pain Group Adults aged 25-60 years with chronic nonspecific neck pain lasting at least 6 months and no headache. Participants undergo one questionnaire-based and instrument-based assessment session. No intervention is assigned.
Healthy Control Group Adults aged 25-60 years with no neck pain or headaches. Participants undergo one questionnaire-based and instrument-based assessment session. No intervention is assigned.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bilateral Upper Trapezius Muscle Stiffness Time Frame: During the single assessment session at enrollment	Upper trapezius muscle stiffness will be assessed bilaterally using the MyotonPRO device. Three consecutive measurements will be obtained at the midpoint between the C7 spinous process and the lateral border of the acromion. The mean of the three measurements will be used. Stiffness will be expressed in newtons per meter (N/m), with higher values indicating greater stiffness.	During the single assessment session at enrollment
Bilateral Upper Trapezius Logarithmic Decrement Time Frame: During the single assessment session at enrollment	Upper trapezius logarithmic decrement will be assessed bilaterally using the MyotonPRO device at the same standardized measurement site. Three consecutive measurements will be obtained on each side, and their mean will be used. Logarithmic decrement is a dimensionless inverse indicator of tissue elasticity, with lower values indicating greater elasticity.	During the single assessment session at enrollment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bilateral Handgrip Strength Time Frame: During the single assessment session at enrollment	Bilateral handgrip strength will be measured using a Jamar Hydraulic Hand Dynamometer set to the second handle position. Participants will perform three maximal contractions with each hand in a standardized seated position. The highest value for each hand will be recorded in kilograms, with higher values indicating greater handgrip strength.	During the single assessment session at enrollment
Bilateral Upper Trapezius Pressure Pain Threshold Time Frame: During the single assessment session at enrollment	Pressure pain threshold will be measured bilaterally over the upper trapezius using a handheld pressure algometer with a 1-cm² probe. The measurement site will be the midpoint between the C7 spinous process and the lateral border of the acromion. Pressure will gradually increase until the participant first reports pain. Values will be recorded in kg/cm², with higher values indicating a higher pressure pain threshold.	During the single assessment session at enrollment
Bilateral Suboccipital Pressure Pain Threshold Time Frame: During the single assessment session at enrollment	Pressure pain threshold will be measured bilaterally over the suboccipital region using a handheld pressure algometer with a 1-cm² probe. The measurement site will be located 2 cm lateral to the C2 spinous process. Pressure will gradually increase until the participant first reports pain. Values will be recorded in kg/cm², with higher values indicating a higher pressure pain threshold.	During the single assessment session at enrollment
Tragus-to-Wall Distance Time Frame: During the single assessment session at enrollment	Tragus-to-wall distance will be measured in millimeters using a tape measure. Participants will stand with their heels, sacrum, and thoracic spine resting comfortably against a wall while maintaining a natural head position. The distance between the wall and the tragus will be recorded. Greater distances indicate greater forward positioning of the head.	During the single assessment session at enrollment
Craniovertebral Angle Time Frame: During the single assessment session at enrollment	The craniovertebral angle will be measured in degrees using a universal goniometer. The fulcrum will be positioned over the lateral projection of the C7 spinous process. The stationary arm will remain parallel to the floor, and the movable arm will point toward the tragus. Three measurements will be obtained, and their mean will be used. Smaller angles indicate greater forward head posture.	During the single assessment session at enrollment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul Medipol University Hospital

Collaborators

Istanbul Kent University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 21, 2026

Primary Completion (Estimated)

October 1, 2026

Study Completion (Estimated)

October 1, 2026

Study Registration Dates

First Submitted

August 17, 2026

First Submitted That Met QC Criteria

August 17, 2026

First Posted (Actual)

August 20, 2026

Study Record Updates

Last Update Posted (Actual)

August 21, 2026

Last Update Submitted That Met QC Criteria