Neck pain w/ headache

Question 1

What are common symptoms of neck pain w/ headache?

Answer 1

• noncontinuous, unilateral neck pain and associated (referred) headache = cervicogenic headache
• headache is precipitated or aggravated by neck movements or sustained posture

Question 2

What are some expected exam findings?

Answer 2

• (+) CFRT
• headache reproduced w/ provocation of the involved upper cervical segments
• limited cervical ROM
• restricted upper cervical segmental mobility
• strength, endurance, and coordination deficits of the neck muscles

Question 3

What would indicated a positive CFRT?

Answer 3

• restriction of rotation ROM w/ a cutoff of less than 32 degrees rotation OR a 10-degree reduction in the visually estimated range to either side

Sn: .90-.95
Sp: .90-.97

Question 4

What is the mean ROM during a CFRT?

Answer 4

Healthy: 39-45 degrees

Cervicogenic headache: 20-28 degrees

Question 5

What are some overall interventions?

Answer 5

• manual therapy and exercise focused on regaining normal mobility
• exercise for cervical and scapulothoracic region (strength, endurance, neuromuscular retraining)

*assess DCF’s & suboccipitals”

Question 6

What are some interventions during the acute stage?

Answer 6

• provide supervised instruction in active mobility exercise
• self-SNAG exercise

Question 7

What are some interventions during the sub-acute phase?

Answer 7

• cervical manipulation and mobilization
• C1-C2 self-SNAG exercise

Question 8

What are some interventions during the chronic phase?

Answer 8

• cervical or cervicothoracic manipulation or mobilizations combined w/ shoulder girdle and neck strengthening, stretching, and endurance