Assessment of the head, cervical spine, thoracic spine and shoulder girdle postures in subjects with and without chronic headache

Abstract

Background and Objectives: Cervical musculoskeletal dysfunction is one of the common symptoms of migraine and cervicogenic headaches. The present study was conducted to clinically assess the posture of the head, cervical spine and thoracic spine, and the shoulder girdle in people with and without cervicogenic and migraine headaches. Materials and Methods: This case-control study was conducted on 20 people with a cervicogenic headache, 20 with migraine and 50 with no reported headaches as the control group. The postural angles of the head, cervical spine and thoracic spine, and the shoulder girdle in frontal and sagittal planes were assessed and measured using the photogrammetry. The thoracic spine curvature was evaluated by a flexible ruler. Results: The craniovertebral angle was found to be lower in a migraine and cervicogenic groups compared to the healthy group. The scapular upward rotation angle (P=0.002) was also lower while the coronal tilt angle (P=0.006) was greater in the migraine group compared to the other two groups. No significant differences were observed among these three groups in the remaining variables (P>0.005). There was no relationship between postural angles in the groups. Conclusion: The results of this study revealed that forward head posture was evident in people with a cervicogenic and migraine headache. Decreased scapular upward rotation seen in migraine headache group highlights the importance of considering possible shoulder girdle related dysfunctions in people with chronic headaches such as migraine.