Features indicative of cervical abnormality. A factor to be reckoned with in clinical headache work and research?

The current criteria for cervicogenic headache (CEH) contain an anamnestic and a physical examination part. The latter consists of: 1) range of motion in the cervical spine (1+); 2) mechanical precipitation of head pain (uppermost score: 1.5+). These two factors are included in "Features indicative of cervical abnormality", outlined in the present context, with a view to possibly facilitating CEH diagnosis. These "features" have a wider scope, containing not only the two original factors (1 and 2), but also three additional factors--their relative contribution to the totality also given in parentheses: 3) facet joint tenderness (0.5+); 4) neck muscle tenderness (0.5+); and 5) skin-roll test (1.0+). The sum of the solitary features is, accordingly, 4.5+. An extra 0.5+ can be added if there is extreme positivity of one of the factors, i.e., a maximum of 5.0+. This coarse system concerning cervical function has also been tested out in 1834 parishioners in the Vågå study of headache epidemiology (irrespective of headache diagnoses). The mean number of features increased with increasing intensity of head pain (by a factor of almost 3). In headache-free individuals (n.=246), the mean was 0.42+, against a mean in the whole series of 0.79+. Reproducibility tests demonstrated relatively high consistency.