Cervical musculoskeletal impairments in cervicogenic headache: a systematic review and a meta-analysis

The differential diagnosis of cervicogenic headache (CEH) requires the presence of a pattern of symptoms and cervical musculoskeletal signs that distinguishes it from other types of headaches. The investigation of cervical musculoskeletal impairments (CMI) can help in the diagnosis and treatment of the CEH. In order to assess the evidence concerning CMI in CEH subjects, a systematic review and a meta-analysis was performed. Several electronic databases were searched. A checklist was used to identify suitable articles and a methodological scale was used to analyse their quality. Ten articles met the inclusion criteria. Based on our meta-analysis, patients with CEH have altered range of motion in rotation, flexion-extension, cervical rotation with cervical flexion, altered cervical flexor strength, and altered cervical flexor endurance. More controlled studies investigating the cervical impairments in CEH, with a clear history of patients, and greater sample sizes, are necessary.