Cervicospinal Posture and Pain in Cervicogenic Headache
Cervicospinal Posture and Pain in Cervicogenic Headache
Cervicogenic headache (CEH) is a type of symptomatic headache that is characterized by
 chronic unilateral headache secondary to cervical spine dysfunction. Generally, it gets worse
 by neck movements, continuous placement of the head in an awkward position and exposure to
 external pressure on the upper cervical or occipital region.

 The pain was demonstrated to originate from lower cervical disc prolapse and spinal nerve
 roots in some studies, while it is suggested in some others to occur due to the upper
 cervical region as well. Although disturbed cervical alignment has been determined in tension
 headache and migraine, there are few studies with controversial results in the literature
 investigating the effects of the change in cervical lordosis on CEH. These contradictory
 results strongly influence the decision of whether exercise should be added to the treatment
 protocol in CEH and also the creation of an appropriate treatment program by the clinicians.
 In light of this background, the aim of this study was to compare the cervical radiographs of
 patients with CEH and patients with neck pain without a headache.
The general demographics, pain status and cervical radiological evaluations of the patients
 was performed in this prospective, cross-sectional, single-blind study evaluating two
 different disease groups compatible in age and gender and the two groups were compared.

 For inclusion in the Cervicogenic Headache group, inclusion criteria determined by the
 Cervicogenic Headache International Study Group (CHISG) were used.

 Symptoms of all patients were questioned in detail and physical examinations were performed.
 After obtaining demographic information such as age, height and weight, severity and duration
 of pain were asked to the patients and Neck Disability Index (NDI) and Visual Analogue Scale
 (VAS) were used for pain assessment Cervical radiographic analysis was evaluated measuring
 general cervical lordosis and upper cervical lordosis on lateral standing X-rays using
 Surgimap®. General cervical lordosis and Upper cervical lordosis measurements were performed
 on the lateral cervical graph.
Inclusion Criteria:

 For Cervicogenic headache group

 -  Unilateral headache, starting from the upper neck/occipital region and spreading to
 the oculofrontotemporal area on the symptomatic side

 -  Pain triggered by neck movements and/or continuous awkward positions

 -  Decreased joint range of motion in the cervical vertebra

 Exclusion Criteria:

 For Cervicogenic headache group

 -  Previously diagnosed to have any other syndromes of headache (Migraine, Tension
 headache, etc.)

 -  Presence of bilateral headache; For the neck pain group,

 -  Presence of 2 or more neurological symptoms (decreased upper extremity muscle
 strength, decreased reflexes and hypoesthesia compatible with the dermatome regions)

 -  Suggesting nerve root compression (radiculopathy, plexopathy); for both groups,

 -  Presence of any signs suspicious of central nervous system involvement (hyperreflexia,
 nystagmus, decreased vision, etc)

 -  Reluctance to participate in the study.