Diagnose headaches with cervical flexion-rotation test

Headache is one of the most common presenting complaint of chiropractic patients. A recent study compared the findings and identified the diagnostic accuracy of the cervical flexion-rotation test (FRT) between subjects with probable cervicogenic headache (CGH), migraine without aura (Migraine), and multiple headache forms (MHF).

Sixty subjects were evaluated: 20 with CGH, 20 with Migraine, and 20 with MHF. The average range of unilateral rotation to the most restricted side was 25 degrees, 42 degrees and 35 degrees for groups CGH, Migraine and MHF, respectively. Range of rotation was significantly reduced in the CGH group when compared to groups Migraine and MHF. The study found that “An experienced examiner using FRT was able to make the correct diagnosis 85% of the time (P<0.001)…”

This recent research continues to confirm the importance of a simple flexion rotation test (FRT) in the differential diagnoses of headaches. Many headache cases are often similar in terms of presenting symptom and the FRT has demonstrated in multiple research studies to be highly sensitive to identifying cervicogenic headache from migraine and multiple headache forms.

Reference: Hall TM, Briffa K, Hopper D, Robinson K. Comparative analysis and diagnostic accuracy of the cervical flexion-rotation test. J Headache Pain. 2010 May 28.

Dr. David P. Chen
Chiropractor in Laurel Maryland
Laurel Regional Chiropractic

Headaches are effectively treated by addressing neck issues.

It is very common when talking to patients for them to separate out neck pain and headaches as two unrelated problems. Before I became a chiropractor, my thinking was that a headache represented some imbalance in the brain. Since the brain has no pain receptors itself, we understood that something outside the brain is the most likely cause. Common causes are muscle spasm or joint problems. When I first started ten years ago, my patients and myself were often both surprised when I treated their necks and their headaches vanished. A recent study found that spinal surgery was effective in relieving headaches in a great number of patients. While surgery has improved, it is unfortunately not the least risky approach to dealing with headaches. A 2007 study on these procedures noted a 1 out of a 1000 risk of death. An earlier meta-analysis identified spinal manipulation as an effective intervention for headaches, comparable in some studies to the relief from pain medication. The risk of death from chiropractic based on most up to date research is considered to be less than 1 in 5 million, this risk is much less than the risk from pain medication.
I would like to point our that I do not talk about the risks to dissuade people from seeking conventional help for headaches, as I firmly believe that all options should be available. I think it's wonderful that the people in the surgical study lost their headaches. In the interest of "first do no harm", chiropractic is a safe option that is often not tried. My colleagues and myself find nothing is quite so fun as taking someone's headache away.