1. Introduction
Headache, headaches, CGH, pain, ache, debilitating illness, tension-type, neck pain, cognitive pain
CERVICOGENIC HEADACHE, PATHOPHYSIOLOGY, CERVICOGENIC HEADACHES, HYPERSENSITIVITY, HEAT, CERVICOGENIC HEADACHE, COLD
Cervicogenic headache (CGH) is unilateral pain that starts in the neck and is referred from bony structures or soft tissues of the neck. It is a common and severe debilitating illness that primarily affects adult females; however, it affects both sexes aged between 20 and 60 years [The cervicogenic headache pathophysiology involves merging pain signals from multiple neck structures on top of the trigeminocervical nucleus in the brainstem [In CGH, the frontal-temporal and orbital regions of the head are affected by the unilateral referred pain of the top three cervical spinal nerves that originates from one side of the posterior head and neck [Criteria for diagnosing CGH have been set by the International Headache Society (IHS) [There is a pattern of typical symptoms that people with CGH experience; however, there may be some variation in their complaints. Symptoms typically start in the neck and progress to the head; furthermore, the symptoms are typically unilateral and do not switch sides. The pain can range in severity from a deep, dull ache to a heavy pressure that is either mild or severe [In previous studies, researchers have reported that people with neck pain and headaches showed a 43%–46% decrease in isometric cervical flexor muscle strength [The role of manual therapy is limited in the treatment of headaches. Despite not being suitable for all forms of headaches, scientific evidence supports the use of a few manual therapies, such as cervical spinal exercises, spinal joint mobilization and manipulation, trigger point therapy, physical therapy using heat and cold packs, ultrasound, electrical stimulation, massage, acupuncture, and cognitive pain approaches, which are based on a nociceptive pain theory and aim to modulate central nervous system hypersensitivity, in the treatment of tension-type and cervicogenic headaches [In CGH patients, the combination of manual treatment and muscle reeducation effectively reduced headaches and enhanced function [