From: J Manipulative Physiol Ther. 2010 Jun;33(5):338-348.
Objective clinical measures for use as surrogate markers of cervicogenic headache pain have not been established. In this analysis, the authors investigate relationships between objective physical examination measures with self-reported cervicogenic headache outcomes.
This was an exploratory analysis of data generated by attention control physical examination from an open-label randomized clinical trial. Of 80 subjects, 40 were randomized to 8 treatments (spinal manipulative therapy or light massage control) and 8 physical examination over 8 weeks. The remaining subjects received no physical examination. Physical examination included motion palpation of the cervical and upper thoracic regions, active cervical range of motion and associated pain, and algometric pain threshold evaluated over articular pillars.
Self-reported outcomes included cervicogenic headache and neck pain and disability, number of cervicogenic headaches, and related disability days. Associations between physical examination and self-reported outcomes were evaluated using generalized linear models, adjusting for sociodemographic differences and study group.
At baseline, number of cervicogenic headache and disability days were strongly associated with cervical active range of motion. Neck pain and disability were strongly associated with range of motion-elicited pain but not later in the study. After the final treatment, pain thresholds were strongly associated with week 12 neck pain and disability and cervicogenic headache disability and disability days.
Cervical range of motion was most associated with the baseline headache experience. However, 4 weeks after treatment, algometric pain thresholds were most associated. No one physical examination measure remained associated with the self-reported headache outcomes over time.
