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Cervicogenic headache: Manual and manipulative therapies

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Abstract

This article reviews current literature on the role of manual medicine in the diagnosis and treatment of cervicogenic headache. Manual diagnostic procedures and treatment procedures are described for the cervical spine. Emphasis is placed on accurate diagnosis using a biomechanical model and precise localization of forces. Muscle energy technique is suggested as a safe and effective treatment when somatic dysfunction of the cervical spine is found in association with the diagnostic criteria for cervicogenic headache. Lastly, a suggested clinical approach to this problem from a manual medicine perspective is given.

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References and Recommended Reading

  1. Greenman PE: Principles of Manual Medicine, edn 2. Baltimore: Williams and Wilkins; 1996:13.

    Google Scholar 

  2. Bogduk N: Cervical causes of headache and dizziness. In Grieve’s Modern Manual Therapy, edn 2. Edited by Boyling JD, Palastanga N. New York: Churchill Livingstone; 1994:317–331.

    Google Scholar 

  3. Bogduk N: The anatomical basis for cervicogenic headache. J Manipulative Physiol Ther 1992, 15:67–70.

    PubMed  CAS  Google Scholar 

  4. Alix ME, Bates DK: A proposed etiology of cervicogenic headache: the neurophysiologic basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle. J Manipulative Physiol Ther 1999, 22:534–539.Reports a new anatomic finding; a direct connection between the dura mater and a suboccipital muscle (rectus capitis posterior minor) supplied by the C1 motor nerve root.

    Article  PubMed  CAS  Google Scholar 

  5. Aprill C, Dwyer A, Bogduk N: Cervical zygapophyseal joint pain patterns. I: A study in normal volunteers. Spine 1990, 15:453–457.

    Article  PubMed  Google Scholar 

  6. Aprill C, Dwyer A, Bogduk N: Cervical zygapophyseal joint pain patterns. II: A clinical evaluation. Spine 1990, 15:458–461.

    Article  PubMed  CAS  Google Scholar 

  7. Jull G, Bogduk N, Marsland A: The accuracy of manual diagnosis for cervical zygapophyseal joint pain syndromes. Med J Aust 1988, 148:233–236.

    PubMed  CAS  Google Scholar 

  8. Nilsson N: Evidence that tension-type headache and cervicogenic headache are distinct disorders. J Manipulative Physiol Ther 2000, 23:288–289.

    Article  PubMed  CAS  Google Scholar 

  9. Martelletti MD, LaTour D, Giacovazzo M: Spectrum of pathophysiological disorders in cervicogenic headache and its therapeutic indications. J Neuromusculoskeletal Syst 1995, 3:182–187.

    Google Scholar 

  10. Vernon H, McDermaid CS, Hagino C: Systematic review of randomized clinical trials of complementary/alternative therapies in the treatment of tension-type and cervicogenic headache. Complement Ther Med 1999, 7:142–155.

    Article  PubMed  CAS  Google Scholar 

  11. Whittingham W, Ellis WB, Molyneux TP: The effect of manipulation (toggle recoil technique) for headaches with upper cervical joint dysfunction: a pilot study. J Manipulative Physiol Ther 1994, 17:369–375.

    PubMed  CAS  Google Scholar 

  12. Nilsson N, Christensen HW, Hartvigsen J: The effect of spinal manipulation in the treatment of cervicogenic headache. J Manipulative Physiol Ther 1997, 20:326–330.

    PubMed  CAS  Google Scholar 

  13. Nilsson N: A randomized controlled trial of the effect of spinal manipulation in the treatment of cervicogenic headache. J Manipulative Physiol Ther 1995, 18:435–440.

    PubMed  CAS  Google Scholar 

  14. Sjaastad O: Cervicogenic headache. In Wolff’s Headache and Other Head Pain, edn 6. Edited by Dalessio DJ, Silberstein SD. New York: Oxford University Press; 1993:203–208.

    Google Scholar 

  15. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society [no authors listed].Cephalalgia 1998, 8(suppl 79):1-96.

  16. Westerhuis P: Cervicogenic headache: a clinician’s perspective. In Craniofacial Dysfunction and Pain. Edited by von Piekartz H et al. Oxford: Butterworth Heinemann; 2001:85–99.The most recent and best review on the subject of diagnosis. It is clearly written, well organized, and comprehensive, and provides a particularly good section on the neuroanatomic basis for this diagnosis.

    Google Scholar 

  17. Vernon H, Steiman I, Hagino C: Cervicogenic dysfunction in muscle contraction headache and migraine: a descriptive study. J Manipulative Physiol Ther 1992, 15:418–429.

    PubMed  CAS  Google Scholar 

  18. Maitland GD: Vertebral Manipulation, edn 5. London: Butterworth; 1986.

    Google Scholar 

  19. Butler DS: The Sensitive Nervous System. Adelaide, Australia: Noigroup Publications; 2000:10–13.

    Google Scholar 

  20. Bogduk N, Mercer S: Biomechanics of the cervical spine. I: Normal kinematics. Clin Biomechan 2000, 15:633–648.A benchmark paper that is the most authoritative, clearly written, and well-referenced paper on this subject. Engineering principles are discussed in terms that are understandable to a clinician.

    Article  CAS  Google Scholar 

  21. Kappler RE: Cervical spine. In Foundations for Osteopathic Medicine. Edited by Ward RC. Baltimore: Williams and Wilkins; 1997:541–546.

    Google Scholar 

  22. Kuchera WA, Kuchera ML: Diagnosis and manipulative treatment: cervical region. In Osteopathic Principles in Practice, edn 2. Columbus, Ohio: Greyden Press; 1994:571–590.

    Google Scholar 

  23. Mitchell FL Jr: Cervical procedures. In The Muscle Energy Manual, vol 1. East Lansing: MET Press; 1995:143–209.

    Google Scholar 

  24. Bourdillon JF, Day EA, Bookhout MR: Detailed examination: the spine. In Spinal Manipulation, edn 5. Oxford: Butterworth Heinemann; 1992:113–120.

    Google Scholar 

  25. Greenman PE: Cervical spine. In Principles of Manual Medicine, edn 2. Baltimore: Williams and Wilkins; 1996:175–204.

    Google Scholar 

  26. Westerhuis P, von Piekartz HJM: Cervicogenic headache: physical examination and management. In Craniofacial Dysfunction and Pain. Edited by von Piekartz H et al. Oxford: Butterworth Heinemann; 2001:100–115.

    Google Scholar 

  27. Gifford LS, Butler DS: The integration of pain sciences into clinical practice. J Hand Ther 1997, 10:86–95.

    PubMed  CAS  Google Scholar 

  28. Lord SM, Barnsley L, Wallis BJ, et al.: Third occipital nerve headache: a prevalence study. J Neurol Neurosurg Psychiatry 1994, 57:1187–1190.

    Article  PubMed  CAS  Google Scholar 

  29. Pikus HJ, Phillips JM: Outcome of surgical decompression of the second cervical root for cervicogenic headache. Neurosurgery 1996, 39:63–71.

    Article  PubMed  CAS  Google Scholar 

  30. Pikus HJ, Phillips JM: Characteristics of patients successfully treated for cervicogenic headache by surgical decompression of the second cervical root. Headache 1995, 35:621–629.

    Article  PubMed  CAS  Google Scholar 

  31. Sjaastad O: Cervicogenic headache: the controversial headache. Clin Neurol Neurosurg 1992, 94(suppl):S147-S149.

    Article  PubMed  Google Scholar 

  32. Hurwitz EL, Aker PD, Adams AM, et al.: Manipulation and mobilization of the cervical spine. A systematic review of the literature. Spine 1996, 21:1746–1759.

    Article  PubMed  CAS  Google Scholar 

  33. Greenman PE: Manual and manipulative therapy in whiplash injuries. In Spine: State of the Art Reviews. Edited by Teasell RW, Shapiro AP. Philadelphia: Hanley & Belfus; 1993:517–530.

    Google Scholar 

  34. Di Fabio RP: Manipulation of the cervical spine: risks and benefits. Phys Ther 1999, 79:50–65.A comprehensive review of the complications that have been encountered with manual treatment of the cervical spine. It covers the subject the most thoroughly and has the most extensive reference list.

    Google Scholar 

  35. Klougart N, Leboeuf-Yde C, Rasmussen LR: Safety in chiropractic practice. Part II: treatment to the upper neck and the rate of cerebrovascular incidents. J Manipulative Physiol Ther 1996, 19:563–569.

    PubMed  CAS  Google Scholar 

  36. Haldeman S, Kohlbeck FJ, McGregor M: Vertebrobasilare dissektion nach zervikalem trauma und wirbelsaulenmanipulation: risikofaktoren und vorangehende halsbewegungen [article in German, abstract available in English]. Manual Medizin 2000, 38:3–16.

    Article  Google Scholar 

  37. Krueger BR, Okazaki H: Vertebrobasilar distribution infarction following chiropractic cervical manipulation. Mayo Clin Proc 1980, 55:322–332.

    PubMed  CAS  Google Scholar 

  38. Senstad O, Leboeuf-Yde C, Borchgrevink C: Frequency and characteristics of side effects of spinal manipulative therapy. Spine 1997, 22:435–441.

    Article  PubMed  CAS  Google Scholar 

  39. Toole JF, Tucker SH: Influence of head position upon cerebral circulation. Arch Neurol 1960, 2:616–623.

    PubMed  CAS  Google Scholar 

  40. Budgell BS, Sato A: The cervical subluxation and regional cerebral blood flow. J Manipulative Physiol Ther 1997, 20:103–107.

    PubMed  CAS  Google Scholar 

  41. Rivett DA, Sharples KJ, Milburn PD: Effect of premanipulative tests on vertebral artery and internal carotid artery blood flow: a pilot study. J Manipulative Physiol Ther 1999, 22:368–375.

    Article  PubMed  CAS  Google Scholar 

  42. Rivett DA, Milburn PD, Chapple C: Negative pre-manipulative vertebral artery testing despite complete occlusion: a case of false negativity? Manual Ther 1998, 3:102–107.

    Article  Google Scholar 

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Grimshaw, D.N. Cervicogenic headache: Manual and manipulative therapies. Current Science Inc 5, 369–375 (2001). https://doi.org/10.1007/s11916-001-0027-9

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