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Background: Office workers are specifically vulnerable to headache conditions. Neck pain is reported by almost 80% of patients with headaches. Associations between currently recommended tests to examine cervical musculoskeletal impairments, pressure pain sensitivity and self-reported variables in headache, are unknown. The aim of this study is to evaluate whether cervical musculoskeletal impairments and pressure pain sensitivity are associated with self-reported headache variables in office workers. Methods: This study reports a cross-sectional analysis using baseline data of a randomized controlled trial. Office workers with headache were included in this analysis. Multivariate associations, controlled for age, sex and neck pain, between cervical musculoskeletal variables (strength, endurance, range of motion, movement control) and pressure pain threshold (PPT) over the neck and self-reported headache variables, such as frequency, intensity, and the Headache-Impact-Test-6, were examined. Results: Eighty-eight office workers with a 4-week headache frequency of 4.8 (±5.1) days, a moderate average headache intensity (4.5 ± 2.1 on the NRS), and “some impact” (mean score: 53.7 ± 7.9) on the headache-impact-test-6, were included. Range of motion and PPT tested over the upper cervical spine were found to be most consistently associated with any headache variable. An adjusted R2 of 0.26 was found to explain headache intensity and the score on the Headache-Impact-Test-6 by several cervical musculoskeletal and PPT variables. Discussion: Cervical musculoskeletal impairments can explain, irrespective of coexisting neck pain, only little variability of the presence of headache in office workers. Neck pain is likely a symptom of the headache condition, and not a separate entity.

Sportler*innen in verschiedenen Sportarten müssen innerhalb kurzer Zeit Entscheidungen treffen, basierend auf ihrer Wahrnehmung der jeweiligen Sport-, und/oder Spielsituation. Dafür benötigen sie unter anderem ein optimal funktionierendes sensomotorisches System, das verschiedene Sinneswahrnehmungen integrieren muss, z.B. in Bezug auf den eigenen Körper, inklusive dessen Position im Raum, sowie der Sport-/Spielsituation, inklusive einem möglicherweise beteiligten Sportgerät (Ball, Schläger etc.) sowie Mitspieler*innen und/oder Gegner*innen. Dieses sensomotorische System muss innerhalb von Bruchteilen einer Sekunde verschiedene sensorische Informationen, z.B. visuelle oder propriozeptive, aufnehmen, diese gewichten und so verarbeiten, dass eine angepasste motorische Reaktion unterschiedlicher motorischer Systeme ausgelöst wird. Diese Reaktion bedient sich dabei, je nach Begabung und Geschicklichkeit der Sportlerin oder des Sportlers abgespeicherter Bewegungsmuster, die jedoch laufend der sich ändernden Situationen angepasst werden müssen. Eine wichtige Säule des sensomotorischen Systems ist die Halswirbelsäule, die auch durch ihre Beweglichkeit die beteiligten Sensoren in die optimale Stellung bringen kann.

Neck pain is a common problem in the general population with high risk of ongoing complaints or relapses. Range of motion (ROM) assessment is scientifically established in the clinical process of diagnosis, prognosis and outcome evaluation in neck pain. Anatomically, the cervical spine (CS) has been considered in two regions, the upper and lower CS. Disorders like cervicogenic headache have been clinically associated with dysfunctions of the upper CS (UCS), yet ROM tests and measurements are typically conducted on the whole CS. A cross-sectional study assessing 19 subjects with non-specific neck pain was undertaken to examine UCS extension-flexion ROM in relation to self-reported disability and pain (via the Neck Disability Index (NDI)). Two measurement devices (goniometer and electromagnetic tracking) were employed and compared. Correlations between ROM and the NDI were stronger for the UCS compared to the CS, with the strongest correlation between UCS flexion and the NDI-headache (r = -0.62). Correlations between UCS and CS ROM were fair to moderate, with the strongest correlation between UCS flexion and CS extension ROM (r = -0.49). UCS flexion restriction is related to headache frequency and intensity. Consistency and agreement between both measurement systems and for all tests was high. The results demonstrate that separate UCS ROM assessments for extension and flexion are useful in patients with neck pain.

Accurate measurements of spinal movement require reliable determination of anatomical landmarks. Current methods of identifying these are not sufficiently reliable or valid for this purpose. A reliable and convenient method of placing markers on selected vertebra is needed to compare measurements between different testers, subjects and sessions.