Usefulness of manipulative therapy of the upper cervical joints in patients with cervicogenic headache - a single system experimental study

Summary of background data: Cervicogenic headache is considered as the third most common headache form by some researchers. Manual therapists diagnose and treat these patients. Cervical manipulative therapy is a treatment that is used to reduce the headache. Purpose and problem statements: To investigate the effect of manipulation of the upper cervical joints regarding headache, neck pain, cervical range of motion and function in patients with cervicogenic headache. Patients and Methods: Two female patients 54 and 55 years old with several years of headache were treated 4 respectively 5 times. The symptoms were reproduced with palpation over the upper cervical column. Cervical range of motion was restricted to the symptomatic side. The outcome measures were the Numerical Rating Scale, Cervical Flexion-Rotation Test and the Patient-Specific Functional Scale. The measurements were made in the baseline, during treatment and at four weeks follow up. Results: There were no changes in headache and neck pain. Cervical Flexion-Rotation Test increased for both patients and the values remained at four weeks follow up. There were no clinically meaningful changes of patient-specific functions except for tiredness in the neck while sitting (patient 1). Conclusion: Manipulation of C0, C1 and C2 in two patients with cervicogenic headache did not change the headache or neck pain but increased rotation in the upper cervical column. There was a small change on patient-specific functions