Mulligan Technique Versus Proprioceptive Training in Cervicogenic Headache

Cervicogenic headache (CGH) is a type of headache, and it occurs commonly due to neck dysfunctions. Many studies found positive association between the neck dysfunction and CGH. The prevalence of this problem is more common in women than men. Headache disorders are classified as primary, such as migraine or tension-type headache, or secondary, such as CGH. The one-year prevalence of CGH in the adult population varies between 0.2 and 2.2%.

It is severely impacts the general public, burdening public health and putting pressure on the local economy and community.

The International Classification of Headache Disorders (ICHD BETA 3) defined cervicogenic headache as "Headache caused by a disorder of the cervical spine and its component bony, disc and/or soft tissue elements, usually but not always accompanied by neck pain.

No drugs are effective for cervicogenic headache. Studies showed that treatment with manual therapy, specific exercises, or manual therapy plus exercises was significantly more effective at reducing headache frequency and intensity than was no treatment. Manual therapy alone, however, was not more effective than exercises alone, and combining the two interventions did not achieve better outcomes than either intervention alone. About 76% of patients achieved a more than 50% decrease in headache frequency and 35% achieved complete relief at the 7-week follow-up. At 12 months, 72% had a more than 50% decrease in headache frequency, but the proportion that had complete relief was not reported.

A recent systematic review concluded that manual therapy may be effective in the short term and neck exercise in the long term in treating adults with cervicogenic headache.