Conclusions : Despite low levels of evidence , manual examination of the cervical spine appears to aid the diagnostic process related to CGH and can be implemented by both experienced and inexperienced examiners
Objective : To evaluate the diagnostic validity of manual examination techniques used to diagnose  cervicogenic headache ( CGH ) .
Background : Cervicogenic headache is a specific type of headache that originates from the cervical spine and is typically chronic in nature .
Diagnostic criteria for CGH have been established by the International Headache Society ( IHS ) and are cited extensively in the literature .
Diagnosis of CGH through manual examination is a more recent practice .
To our knowledge , no systematic review of manual diagnosis of CGH has been performed .
Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache.
Persistent intermittent headache is a common disorder and is often accompanied by neck aching or stiffness , which could infer a cervical contribution to headache . However , the incidence of cervicogenic headache is estimated to be 14 - 18 % of all chronic headaches , highlighting the need for clear criterion of cervical musculoskeletal impairment to identify cervicogenic headache sufferers who may benefit from treatments such as manual therapy . This study examined the presence of cervical musculoskeletal impairment in 77 subjects , 27 with cervicogenic headache , 25 with migraine with aura and 25 control subjects . Assessment s included a  photographic measure of posture , range of movement , cervical manual examination , pressure pain thresholds , muscle length , performance in the cranio-cervical flexion test and cervical kinaesthetic sense .  The results indicated that when compared to the migraine with aura and control groups who scored similarly in the tests , the cervicogenic headache group had less range of cervical flexion/extension ( P=0.048 ) and significantly higher incidences of painful upper cervical joint dysfunction assessed by manual examination ( all P<0.05 ) and muscle tightness ( P<0.05 ) . Sternocleidomastoid normalized EMG values were higher in the latter three stages of the cranio-cervical flexion test although they failed to reach significance . There were no between group differences for other measures . A discriminant analysis revealed that manual examination could discriminate the cervicogenic headache group from the other subjects ( migraine with aura and control subjects combined ) with an 80 % sensitivity
Conclusions : Despite low levels of evidence , manual examination of the cervical spine appears to aid the diagnostic process related to CGH and can be implemented by both experienced and inexperienced examiners
Objective : To evaluate the diagnostic validity of manual examination techniques used to diagnose  cervicogenic headache ( CGH ) .
Background : Cervicogenic headache is a specific type of headache that originates from the cervical spine and is typically chronic in nature .
Diagnostic criteria for CGH have been established by the International Headache Society ( IHS ) and are cited extensively in the literature .
Diagnosis of CGH through manual examination is a more recent practice .
To our knowledge , no systematic review of manual diagnosis of CGH has been performed .