Effectiveness of Craniosacral Therapy in Cervicogenic Headache

Headache is common phenomenon experienced by everyone at some point in their lives. Hence it’s not surprising that the global estimate of headache sufferers is around 46% and prevalence of Cervicogenic headache is 2.5-4.1% among all headache types [1,2]. This prevalence might appear to be relatively low as compared to other headache types like migraine or tension type headache but the associated disability is alarming and high. Cervicogenic Headache (CGH) arises mainly from dysfunction in the first three upper cervical segments [3]. The probable pathway by which pain initiating in the neck can be referred as a headache is the trigeminocervical nucleus which descends in the spinal cord to the area of C3 or sometimes C4. These structures are further in anatomical continuity with the dorsal gray columns of the same spinal segments [4]. Therefore, input from sensory afferents primarily from any of the upper three cervical nerve roots can be mistaken to be perceived as pain in the head3 through a process called as convergence. Although the pathophysiology is not totally clear there are definite articular, muscular and neural mechanisms which are at play [5]. The average age of onset has been marked as 33-43 years and the mean of the duration of presence of symptoms at 7-17 years [1,2]. The chronicity seems to develop through increase in frequency of headache which are short lasting and not continuous or unrelenting.