Chiropractic spinal manipulative therapy for cervicogenic headache: a study protocol of a single-blinded placebo-controlled randomized clinical trial

doi:10.1186/s40064-015-1567-5

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Springerplus. 2015; 4: 779.

Published online 2015 Dec 16. doi: 10.1186/s40064-015-1567-5

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Table 1

Diagnostic criteria for cervicogenic headache by the Cervicogenic Headache International Study Group

Major criteria^a

1. Symptoms and signs of neck involvement

a. Precipitation of head pain, similar to the usually occurring one:

i. By neck movement and/or sustained awkward head positioning, and/or:

ii. By external pressure over the upper cervical or occipital region on the symptomatic side

b. Restriction of range of motion (ROM) in the neck

c. Ipsilateral neck, shoulder, or arm pain of a rather vague nonradicular nature or,
occasionally, arm pain of a radicular nature.

2. Confirmatory evidence by diagnostic anesthetic blockade

3. Unilaterality of the head pain, without side shift

Head pain characteristics

4. Moderate-severe, non-throbbing, and non-lancinating pain, usually starting in the neck.
Episodes of varying duration, or: fluctuating, continuous pain

Other characteristicsof some importance

5. Only marginal effect or lack of effect of indomethacin. Only marginal effect or lack of effect of ergotamine
and sumatriptan. Female sex. Not infrequent occurrence of head or indirect neck trauma by history, usually
of more than only medium severity.

Other features of lesser importance

6. Nausea. Phonophobia and photophobia. Dizziness.
Ipsilateral “blurred vision”. Difficulties swallowing. Ipsilateral edema, mostly in the periocular area

^a It is obligatory that one or more of phenomena 1a–c are present

Diagnostic criteria for cervicogenic headache by the
International Classification of Headache Disorders-II

A. Pain, referred from a source in the neck and perceived in one or more regions of the head and/or face,
fulfilling criteria C and D

B. Clinical, laboratory and/or imaging evidence of a disorder or lesion within the cervical spine or soft tissues
of the neck known to be, or generally accepted as, a valid cause of headache

C. Evidence that the pain can be attributed to the neck disorder or lesion based on at least one of the following:

i Demonstration of clinical signs that implicate a source of pain in the neck

ii Abolition of headache following diagnostic blockade of a cervical structure or its nerve supply using placebo-
or other adequate controls

D. Pain resolves within 3 months after successful treatment of the causative disorder or lesion