Neck Pain w/ Cervicogenic Headaches

Question 1

Clinical Presentation

Answer 1

• Noncontinuous unilateral neck pain & associated headache
• Headache is precipitated by neck movements or sustained postures

Question 1

Tests & Measures

Answer 1

• Cervical Flexion and Rotation Test (CFRT)
• OA Flexion mobility assessment
• Cranio-Cervical flexion test (CCFT)
• Suboccipital palpation
• Cervical ROM
• Upper cervical PAIVM

Question 2

Exam Findings

Answer 2

(+) Cervical Flexion Rotation Test (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

Interventions (manual therapy)

Answer 3

• Supine OA Flexion/Extension hold-relax
• Supine craniocervical (C0-C1) A-P mobilization
• Occiput to C1 (OA) distraction
• UPA C0-C1
• Upper Cervical CPA
• Supine suboccipital STM
• Supine cervical flexion rotation treatment
• Cervical/Thoracic manipulation

Question 4

Exercise

Answer 4

• Augmented Upper Cervical mobility rotation/extension
• Exercise for cervical and scapulothoracic region: strengthening and endurance exercises w/ neuromuscular training, including motor control and biofeedback elements
• Stretching, strengthening, and endurance training elements