Prevalence of cervicogenic headache and functional disability associated with use of personal protective equipment in front line health care providers during COVID-19 in Lahore, Pakistan

Objective: To determine the prevalence of cervicogenic headache and functional disability associated with using personal protective equipment (PPE) by front-line health care providers during covid19 in Lahore, Pakistan.Methodology: This cross-sectional study included 98 front line health care providers who were enrolled using a non-probability convenient sampling technique and was carried out from February to August 2021. The data were collected from the University of Lahore teaching hospital, Mayo hospital and Bahria International hospital, Lahore. Diagnostic criterion included headache typically started in the temporal, cervical and occipital region, pain originated due to problem in cervical region and resolution of symptoms with cervical disorder improvement, limited cervical range of motion as well as increase in headache with cervical movements, any nerve impingement in cervical spine. The Neck disability Index and VAS questionnaire were used which were filled on the spot.Results: Out of 98 participants, 61 (62.2%) were females with a mean age of 33.60 +/- 6.89 years. Pain was triggered within 91 to 120 minutes (1.5 - 2 hours) of wearing a face mask in 38 (38.6%) and protective eyewear in 36 (36.7%) healthcare workers. In total, 51 (56.7%) subjects developed cervicogenic headache during COVID-19. Statistically significant association was found between duration of PPE wear (both face mask and eye-protective wear) and cervicogenic headache as well as functional disability (p<0.001).Conclusion: Prevalence of cervicogenic headache associated with PPE use was 56.7% in frontline healthcare workers. There was a significant association between cervicogenic headache and the use of PPE.