Reproduction and resolution of familiar head pain with upper cervical spine sustained joint mobilization may help identify cervicogenic headaches: a case-control study

Damien Cummins, Darren A Rivett, Lucy C Thomas, Peter G Osmotherly, Damien Cummins, Darren A Rivett, Lucy C Thomas, Peter G Osmotherly

Abstract

Background: The relative value of clinical tests toward identifying cervicogenic headache (CGH) remains under investigated. Whilst certain physical examination findings have been associated with CGH, consensus on which findings provide the strongest association remains elusive.

Objectives: To determine which cervical musculoskeletal assessment procedures used in CGH are positively associated with CGH.

Design: Single blind observational study.

Methods: Four selected musculoskeletal assessment procedures of the cervical spine, craniocervical flexion test, cervical flexion-rotation test, cervical retraction range of motion and reproduction and resolution of familiar head pain with upper cervical spine sustained joint mobilization, were applied to 20 headache and 20 controls. Inclusion criteria for the headache group met the International Headache Society criteria for CGH except positive diagnostic blocks.

Results: Upper cervical spine sustained joint mobilization testing associated with reproduction and resolution of familiar head pain was strongly associated with CGH (Odds Ratio = 36, p < 0.01). This was 78% sensitive and 90% specific in identifying CGH. Other physical tests were not statistically associated with CGH.

Conclusions: Reproduction and resolution of familiar head pain with upper cervical spine sustained joint mobilization is effective in differentiating those with CGH from control participants. Other cervical measures did not clearly identify CGH in this study.

Keywords: Cervicogenic headache; cervical spine; diagnostic testing; manual examination; sustained joint mobilization.

Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
The cervical flexion rotation test (CFRT) with FASTRAK electromagnetic movement tracking device in-situ.
Figure 2.
Figure 2.
Retraction with therapist overpressure as described by McKenzie and May (2006a, p. 231).
Figure 3.
Figure 3.
Assessment of substitution strategies while monitoring performance of the cranio-cervical flexion test.
Figure 4.
Figure 4.
A. Central C3 spinous process sustained posterior to anterior (PA) mobilization. b. Right unilateral PA C2–3 sustained joint mobilization. c. Left unilateral PA O-C1 sustained joint mobilization.

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Source: PubMed

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