Cervicogenic Headache / Cervical Tension Headache

• The presence of Cervicogenic headaches varies in the general population depending on the criteria used to define it.  Using the Cervicogenic Headache International Study Group’s criteria, it is estimated the prevalence ranges between 1.0% (six positive criteria) and 4.6% (5 positive criteria) in the general population.
• Estimates suggest that cervical tension headaches account for approximately 15% to 20% of patients with chronic headaches. 
• One peer review research paper found cervicogenic headaches have a 4:1 female ratio.

Pathophysiology
‍
Cervical tension headaches consist of unilateral headache that is often distributed in a “rams horn” pattern, involving one side of the neck, back of the head and temple.  These symptoms are thought to originate from the cervical spine and may cause symptoms including aching, burning and migraine type pain.  Potential structures involved in this condition include neck musculature, cervical vertebrae (especially the 1st, 2nd and 3rd cervical vertebra) and nerve tissue.  
‍
Aggravating factors often include driving, typing at the computer, carrying objects and/or other activities that require neck movement and/or sustained awkward head and neck positions.  
‍
Physical therapy for cervical tension headaches includes assessing cervical vertebral mobility, cervical musculature length and deep neck flexor strength.  A plan of care to address impairments is then created with an emphasis on reducing frequency and intensity of symptoms.  If applicable, an ergonomic assessment is conducted to improve posture while seated at a desk or work station.