Cervicogenic Headache

The last time I looked at a headache classification document there were 100+ different types of headache, so we need to be specific here, cervicogenic headaches are those which develop from the neck, more specifically those arising from joints and muscles of the neck and shoulders. The head pain is precipitated by neck movement, sustained awkward head positioning, or external pressure over the upper cervical or occipital region on the symptomatic side [Cephalgia, 2004, Sjaastad et al 1998). Like most other complaints diagnosis is made primarily through case history and examination, however here we also want to see a negative neurological examination, especially the cranial nerves.
A Cochrane review (Bronfort et al, 2004) using a pre-specified, detailed protocol for synthesizing the evidence from the quality, quantity, and results of RCTs concluded that spinal manipulation is an effective option for management of cervicogenic headache, along with specific neck exercises. A more recent review of the evidence (Clar et al, 2014) suggested that there was no additional quality evidence for the management of cervicogenic headache and therefore spinal manipulation remains a positive intervention for care.

The International Classification of Headache Disorders. Cephalalgia , 2 2004, 24(Suppl 1):9-160.
Sjaastad O, Fredriksen TA, Pfaffenrath V: Cervicogenic headache: diagnostic criteria. Headache 1998, 38:442-445.
Bronfort G, Nilsson N, Haas M, Evans R, Goldsmith CH, Assendelft WJ, et al: Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev 2004, CD001878.
Clar, Tsertsvadze, Court, Hundt, Clarke and Sutcliffe. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report: Chiropractic & Manual Therapies 2014, 22:12

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