Deep Cervical Muscle Dysfunction and Head/Neck/Face Pain
by Leonard B. Goldstein, DDS, PhD and Howard W. Makofsky, PT, DHSc, OCS
 Nearly fifty percent (50%) of the population is affected by
cervical spine pain and/or headaches during their lives.1 Headache is not only
one of the most common human ailments,2 but also accounts for the expenditures
of billions of health care dollars annually and is a leading cause of lost time from work.3
Cervical dysfunction may be seen in up to seventy percent (70%) of the population
suffering from any type of headache.4 This suggests that the cervical spine may
be either a causative or contributing factor in the pathogenesis of many headaches.5
The pilot study by Placzek, Pagett, et al. demonstrated and supported the theory that
headache may be influenced by cervical muscle strength, and that weakness of the cervical
spine musculature may lead to abnormal stress on the upper cervical facets which are
related to head and neck pain. It is further speculated that stability, and thus normal
function and biomechanics, is dependent on a balance of anterior and posterior cervical
muscle balance. Despite advances, the pathogenesis of tension-type headache is not clearly
understood. However, cervical musculoskeletal abnormalities have been linked to multiple
headache types.6-8
In the study published by Fernandez-De-Las-Penas, Perez-De-Heredia, Molero-Sanchez, and
Miangolarra-Page,9 the authors presented results similar to those previously
reported:
- impairment in deep neck flexor muscles in individuals with cervicogenic headaches, and
- deficits in the performance of the cranio-cervical flexion test (ie., reduced endurance
or holding capacity of the deep neck flexor muscles).
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— Jan/Feb 2009
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