Conservative physical therapy management for the treatment of cervicogenic headache

Cervicogenic Headache (CGH) affects 22‐25% of adults with women being four times more affected than males. CGHs are suspected to stem from musculoskeletal impairments in the neck with symptoms most commonly consisting of suboccipital neck pain, dizziness, and lightheadedness. Currently, both invasive and non-invasive techniques are available to deal with these symptoms; however, the efficacy of non-invasive treatment techniques has yet to be established.Computerized searches of CINAHL, ProQuest, PubMed, MEDLINE, and SportDiscus, were performed to obtain a qualitative analysis of the literature. One computerized database search and two hand searches yielded six articles. Of the six included randomized controlled trials, all were considered to be of ‘good quality’ utilizing the physiotherapy evidence-based database scale. The interventions utilized were: therapist-driven cervical manipulation and mobilization, self-applied cervical mobilization, cervico-scapular strengthening, and therapist-driven cervical and thoracic manipulation.

Aside from one study, all reported reduced pain and disability, along with improvement in function. The review utilized calculated effect sizes allowing comparison of intervention groups between studies. A combination of therapist-driven cervical manipulation and mobilization with cervico-scapular strengthening was shown to be most effective for reducing pain outcomes in patients suffering from CGH.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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