Cervicogenic Headache in Cervical Radiculopathy Patients: Prevalence and Associated Factors

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Published Apr 12, 2026
https://doi.org/10.62438/tunismed.v104i03.5866
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Vol. 104 No. 03 (2026): Tunis Med Mar 2026

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Anis Jellad
Department of Physical Medicine and Rehabilitation, Research Laboratory of Technology and Medical Imaging - LR12ES06, Center for Musculoskeletal Biomechanics Research, Faculty of Medicine, University of Monastir, Tunisia.
Ahmed Alaqad
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Tunisia.
Amr Chaabeni
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Tunisia.
Imen Dghim
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Tunisia.
Amine Kalai
Department of Physical Medicine and Rehabilitation, Research Laboratory of Technology and Medical Imaging - LR12ES06, Center for Musculoskeletal Biomechanics Research, Faculty of Medicine, University of Monastir, Tunisia.
Mahbouba Jguirim
Department of Rheumatology, Monastir, Research Laboratory of Technology and Medical Imaging - LR12ES06, Center for Musculoskeletal Biomechanics Research, Faculty of Medicine, University of Monastir, Tunisia.
Zohra Ben Salah Frih
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Tunisia.
Mohamed Hedi Bedoui
Research Laboratory of Technology and Medical Imaging - LR12ES06, Center for Musculoskeletal Biomechanics Research, Faculty of Medicine, University of Monastir, Tunisia.

Abstract

Background : Cervicogenic headache (CGH) is frequently associated with cervical radiculopathy (CR), but its prevalence and contributing factors in
patients undergoing conservative treatment are not well established.
Aim : To assess the prevalence of CGH and identify the factors associated with it among patients with CR undergoing conservative treatment.
Methods: A cross-sectional analytical study was conducted from May 2023 to December 2023 in the Physical Medicine and Rehabilitation (PMR) of
Monastir, Tunisia. Patients with CR consulting in PMR and Rheumatology departments were included. The prevalence of CGH was evaluated using
the IHS diagnostic criteria, and associated factors were analyzed.
Results: CGH was diagnosed in 53 out of 86 patients (61.6%) with CR. Univariate analysis revealed that limitations in right cervical rotation, impaired
cervical spine proprioception, reduced neck flexor and extensor strength, functional impairment, high anxiety levels, and lower scores in the physical and mental health domains of quality of life were associated with CGH. Multivariate analysis identified high anxiety score (OR=1.44; 95% CI 1.04–1.98; p=0.024), limitation of right cervical rotation (OR=0.80; 95% CI 0.70–0.90; p < 0.001), and impaired proprioception during flexion
(OR=1.38; 95% CI 1.08–1.76; p=0.009) as independent factors associated with CGH.
Conclusion: CGH seems to be highly prevalent in CR patients undergoing conservative treatment. This study suggests that key factors associated
with CGH are proprioception deficit, anxiety, and reduced quality of life. Further large-scale studies are needed to confirm these findings.

Keywords:

Cervical neuropathy, Cephalagia, Diagnostic criteria, Epidemiology

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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