Relationship Between Cervical Range Of Motion And Headache Disability In Patients With Cervicogenic Headache: A Prospective Longitudinal Study

Abstract

Background: A common type of secondary headache disorder that occurs in the individual with neck pain, restricted cervical mobility, and significant functional disability is cervicogenic headache (CGH). Cervical ROM impairment is often considered to be a main feature of CGH. However, it is unclear how it relates to headache-related disability over time.

Objectives: To investigate the cervical ROM and headache disability relationship in cervicogenic headache patients and determine the association of improvement of cervical mobility with headache-related disability over time.

Methods: A prospective longitudinal observational study was conducted to observe 104 patients with cervicogenic headache. Participants were assessed at baseline and at 3 and 6 months. We used cervical range of motion (ROM), the Headache Disability Index (HDI), Neck Disability Index (NDI), the Visual Analogue Scale (VAS), and the Short Form-36 scale (SF-36) as outcome measures. We conducted a series of analyses including repeated-measures ANOVA, Pearson correlation analysis, and multiple linear regression.

Results: Significant improvements were observed in cervical flexion, extension, and bilateral rotation over the six-month follow-up period (all p < .001). HDI, NDI, and VAS scores decreased significantly, while SF-36 scores improved significantly (all p < .001). Pearson correlation analysis demonstrated significant negative associations between cervical ROM and headache disability across all assessment periods (r = −0.630 to −0.787, p < .001). Multiple regression analysis showed that changes in cervical ROM significantly predicted changes in headache disability (R² = .565, p < .001).

Conclusion: Patients with cervicogenic headache exhibit a strong association between reduced cervical range of motion and increased headache-related disability. Better cervical ROM has strong associations with less disability, indicating that assessment and rehabilitation of cervical mobility is important in the management of cervicogenic headache.