Characterization of cervicogenic headache

Headache is a symptom commonly treated by physical therapies. Towards evidence based practices, these therapies are being evaluated in randomized controlled trials. Tension headache has received most attention. Logically, physical treatments of the cervical musculoskeletal system are appropriate for the management of headaches arising from neck dysfunction; that is, cervicogenic headache. There are difficulties in always selecting suitable headache patients for study and for treatment in everyday clinical practice. This review examines the characteristics of cervicogenic headache for differential diagnosis. There is considerable symptomatic overlap between cervicogenic headache and other chronic headache forms such as tension headache and migraine without aura. The symptomatic criteria for cervicogenic headache are well researched, but current physical diagnostic criteria are often non-specific and non-discriminatory. The possibilities for new physical diagnostic criteria are explored with the aim of helping the clinician and researcher to better identify the cervicogenic headache patient. These are based on current research into physical impairments in the musculoskeletal system with neck pain.