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Table 1

Return to:   Manual Therapies for Cervicogenic Headache: A Systematic Review

Diagnostic criteria of cervicogenic headache

Cervicogenic Headache International Study Group [3]
Major criteriaa1.Symptoms and signs of neck involvement
a. Precipitation of head pain, similar to the usually occurring one:
   i. By neck movement and/or sustained awkward head positioning, and/or:
   ii. By external pressure over the upper cervical or occipital region on the symptomatic side
b. Restriction of range of motion (ROM) in the neck
c. Ipsilateral neck, shoulder, or arm pain of a rather vague nonradicular nature or, occasionally, arm pain of a radicular nature.
2.Confirmatory evidence by diagnostic anesthetic blockade
3.Unilaterality of the head pain, without side shift
Head pain characteristics4.a. Moderate-severe, non-throbbing, and non-lancinating pain, usually starting in the neck.
b. Episodes of varying duration
c. Fluctuating, continuous pain
Other characteristics of some importance5.a. Only marginal effect or lack of effect of indomethacin
b. Only marginal effect or lack of effect of ergotamine and sumatriptan
c. Female sex
d. Not infrequent occurrence of head or indirect neck trauma by history, usually of more than only medium trauma
Other features of lesser importance6.a. Nausea
b. Phonophobia and photophobia
c. Dizziness
d. Ipsilateral “blurred vision”
e. Difficulties swallowing
f. Ipsilateral edema, mostly in the periocular area

International Classification of Headache Disorders-II [5]
A. Pain, referred from a source in the neck and perceived in one or more regions of the head and/or face, fulfilling criteria C and D
B. Clinical, laboratory and/or imaging evidence of a disorder or lesion within the cervical spine or soft tissues of the neck known to be, or generally accepted as, a valid cause of headache
C. Evidence that the pain can be attributed to the neck disorder or lesion based on at least one of the following:
   i. Demonstration of clinical signs that implicate a source of pain in the neck
   ii. Abolition of headache following diagnostic blockade of a cervical structure or its nerve supply using placebo- or other adequate controls
D. Pain resolves within 3 months after successful treatment of the causative disorder or lesion
aIt is obligatory that one or more of phenomena 1a-1c are present