Neck Mobility in Different Headache Disorders


Dr. John-Anker Zwart, Department of Neurology, Regionsykehuset i Trondheim, 700t Trondheim, Norway.


The main purpose of this study was to assess neck mobility (by Cybex equipment) in different headache disordered and, in particular, cervicogenic headache, and to compare; these findings with those in controls. A total of 51 control subjects and 90 headache patients were investigated, whereof 28 patients suffered from common migraine (migraine without aura), 34 from tension-type headache (H episodic and 25 chronic), and 28 patients from cervicogenic headache. One-way ANOVA and post hoc Bonferroni analysis showed significant differences between those with cervicogenic headache and the other groups for rotation ( P <0.001) and flexion/extension ( P <0.001), but not for lateral neck movement ( P =NS). There were no significant differences between migraine patients, tension-type headache patients, and controls. In all four groups, there was a significant positive correlation between active and passive neck movement for rotation ( P <0.001), flexion/extension ( P <0.001), and lateral neck movement ( P <0.001). Repeated measures analysis of variance (ANOVA) showed no significant day-to-day differences in 10 control subjects. In the control group (n=51), there was a significant negative correlation between age and neck movement. For rotation. Pearson's correlation coefficient was: r =-0.71 ( P <0.001), for flexion/extension r =-0.71 ( P <0.001), and for lateral neck movement r =-0.67 ( P <0.001). No significant sex difference was found as for any of the neck movements. Pain at the time of investigation did not seem to influence neck mobility. Cervicogenic headache has been recognized as a pair syndrome by the International Association for the Study of Pain (IASP). Since reduced neck mobility is one of the major criteria for this diagnosis, it emphasizes the need for systematic, objective neck mobility measurements in the individual patient to substantiate the diagnosis. The technique is simple and proved reliable.