title: An investigation of cervical spinal posture in cervicogenic headache.
abstract: BACKGROUND
  Cervicogenic headache (CGH) is defined as headache symptoms originating from the cervical spine. Cervical dysfunction from abnormal posture has been proposed to aggravate or cause CGH, but there are conflicting reports as to whether there is an association between posture and CGH.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate differences in cervical spinal posture, measured on radiographs, between patients with probable CGH and asymptomatic control participants.
  
  
  METHODS
  A single-blinded comparative measurement design was used.
  
  
  METHODS
  Differences in postural variables from radiographs between participants with CGH (n=30) and age- and sex-matched asymptomatic control participants (n=30) were determined using paired t tests or the nonparametric equivalent. Postural variables were general cervical lordosis (GCL, Cobb angle C2-C7), upper cervical lordosis (UCL, sagittal alignment C2 compared with C3-C4), and C2 spinous process horizontal deviation. Logistic regression determined postural variables, increasing the likelihood of CGH.
  
  
  RESULTS
  There were no significant differences in posture between the CGH and control groups. The mean GCL was 10.97 degrees (SD=7.50) for the CGH group and 7.17 degrees (SD=5.69) for the control group. The mean UCL was 11.86 degrees (SD=6.46) for the CGH group and 9.44 degrees (SD=4.28) for the control group. The mean C2 spinous process horizontal deviation was 3.00 mm (SD=1.66) for the CGH group and 2.86 mm (SD=2.04) for the control group. However, there was a significant association between greater GCL and an increased likelihood of having CGH (odds ratio=1.08; 95% confidence interval=1.001, 1.191).
  
  
  CONCLUSIONS
  The findings are limited to an association between GCL and posture, as cause and effect cannot be determined.
  
  
  CONCLUSIONS
  The association between greater GCL and increased likelihood of having CGH suggests that GCL might be considered in the treatment of patients with CGH. However, as the data do not support posture as a cause of CGH, it is unknown whether addressing posture would reduce CGH.
authors.affiliation: P.K. Farmer, BAppSc(Physio), MPhil(Physio), Thrive Physio Health Clinic, Erina, New South Wales, Australia.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Farmer
authors.affiliation: S.J. Snodgrass, PT, PhD, MMedSc(Physio), Discipline of Physiotherapy, School of Health Sciences, Faculty of Health and Medicine, Hunter Building, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia 2308. Suzanne.Snodgrass@newcastle.edu.au.
authors.forename: Suzanne J
authors.initials: SJ
authors.lastname: Snodgrass
authors.affiliation: A.J. Buxton, DipAppSc(Med Rad), MHEd, Discipline of Medical Radiation Science (Diagnostic Radiography), School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Buxton
authors.affiliation: D.A. Rivett, PhD, MAppSc(ManipPhty), BAppSc(Phty), Discipline of Physiotherapy, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle.
authors.forename: Darren A
authors.initials: DA
authors.lastname: Rivett
mesh_terms: D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006261:Headache / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D011859:Radiography