Is it possible to distinguish cervicogenic headache from neck pain with cervicospinal posture? A single-blind, prospective cross-sectional trial

Abstract

Background: Cervicogenic headache (CEH) is a type of headache that is considered to be originated from the upper cervical spine. There are conflicting results in studies showing changes in the cervical spine in patients with CEH. Objectives: We aimed to compare the cervical radiographs of patients with CEH and nonspecific neck pain. Study Design: A single-blind, prospective study. Setting: The department of neurosurgery and physical medicine and rehabilitation in a university hospital. Methods: In this cross-sectional study; 45 women with CEH and 45 women with neck pain were involved. The pain assessment of the patients was done by the Visual Analog Scale (VAS), and the disability assessment was tested with the Neck Disability Index (NDI). General cervical lordosis (GCL) and upper cervical lordosis (UCL) angles were calculated on the lateral cervical x-ray. Clinical parameters including age, weight, height, pain (VAS), disability (NDI), and disease duration were recorded. Patients with CEH and neck pain were compared. Correlations between GCL, UCL, and pain assessment were analyzed. Results: Both groups were demographically similar. There was no significant difference at the lateral cervical x-ray measurements between CEH and neck pain groups (CEH group mean GCL = 19.2, UCL = 13.6; neck pain group mean GCL = 19.1, UCL= 14.8). The positive correlation between GCL and UCL in the neck pain group (r = 0.453; P = 0.002) was not found in the CEH group (P > 0.05). Limitations: Anesthetic blockade was not used for the diagnosis. Also, the whole spinal alignment was not evaluated. Conclusions: According to cervical lateral x-ray, there was no significant difference in posture in patients with CEH and neck pain.