“Cervicogenic headache and its associated symptoms are typically the result of stiff joints in the neck, more specifically the upper portion of the neck” compensatory patterns of other muscles. He is instructed to hold this position for a certain amount of time, and repeats this action for a certain amount of repetitions. Additional exercises are performed in physical therapy to promote strength and endurance of the neck muscles and upper back muscles. Other physical therapy interventions used to address cervicogenic headache include, and are not limited to: soft tissue massage; cardiovascular exercise; education on posture and body mechanics; stretching; and, pain relieving modalities. Individuals should expect to attend physical therapy sessions 2 to 3 times per week for 3 to 6 weeks. With appropriate treatment from a physical therapist who specializes in headache interventions, one can expect a decrease or resolution in cervicogenic headache signs and symptoms. HW Suggested reading: Biondi, D. Cervicogenic headache: A review of diagnostic and treatment strategies. JAOA. April 2005;105 (4). Chaibi, A et al. Manual therapies for cervicogenic headache: A systematic review. J Headache Pain. 2012; 13: 351-359. Fernandez de las Penas, C, et al. Clinical reasoning for manual therapy management for cervicogenic headache. JMMT. 2004; 22 (1): 45-51. Farmer, P et al. An investigation of cervical spine posture in cervicogenic headache. Physical Therapy. February 2015; 95 (2): 212-222. Hall, T et al. Clinical evaluation of cervicogenic headache: A clinical perspective. Man Manip Ther. 2008; 16(2): 73–80. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 3rd edition (beta version). 2013. Cephalalgia 2013; 33 (9): 629-808. Jull, G et al. Trial of management of cervicogenic headache. Pine 2002; 27 (17):1835-1843. Winkel D. Differential Diagnosis of the Spine: Nonoperative Orthopedic Medicine and Manual Therapy. PRO-ED, Inc; 1996. HW 24 HeadW ise ® | Volume 4, Issue 4 • 2015 Denise Schneider, PT, performs manual therapy on a patient to address upper cervical joint stiffness and decreased range of motion of the head/neck.