Cervicogenic headaches: an evidence-led approach to clinical management

Abstract

Cervicogenic headache (CGH), as the diagnosis suggests, refers to a headache of cervical origin. Historically, these types of headaches were difficult to diagnose and treat because their etiology and pathophysiology was not well-understood. Even today, management of a CGH remains challenging for sports rehabilitation specialists. The purpose of this clinical suggestion is to review the literature on CGH and develop an evidence-led approach to assessment and clinical management of CGH.

Keywords: Headache; muscle imbalance; neck pain.

Figures

Figure 1.

Janda's Upper Crossed Syndrome. (Permission of Human Kinetics)

Figure 2a and 2b.

Janda's Cervical Flexion text (a. Normal, b. Abnormal movement patterns)

Figure 3.

The CCF Test. The patient performs craniocervical flexion while maintaining a specific pressure, beginning at 20 mm Hg and ending at 30 mm Hg.

Figure 4.

Cervical Flexion-Rotation Test. The cervical spine is fully flexed and rotated to right and left while noting range of motion and pain. (From: Hall, Toby; Briffa, Kathy; Hopper, Diana, ‘Clinical Evaluation of Cervicogenic Headache: A Clinical Perspective’, Journal of Manual & Manipulative Therapy, 16(2), 2008, pp. 73-80. Used with Permission of Maney Publishing)

Figure 5.

Dynamic Cervical Extension Exercise. The patient performs a ‘hip hinge’, stabilizing the cervical spine against the resistance in 4 directions (Used with permission of The Hygenic corporation).

Figure a-b:

Craniocervical flexion against elastic band loop. Begin with cervical spine in protraction (a). Maintain hand position while retracting against the tension in the band (b). (Used with permission of The Hygenic Corporation).

Figure 7.

Cervical stabilization using a mini-ball with resisted scapular retraction (Used with permission of The Hygenic Corporation).