Movement testings are more reliable than other diagnostic methods in cervicogenic headache (CGH) but validity remains a question.

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According to Haldeman S et al (2001) the notion that headaches may originate from disorders of the cervical spine and can be relieved by treatments directed at the neck is gaining recognition among headache clinicians.. There remains considerable controversy and confusion on all matters pertaining to the topic of CGH. However, the amount of interest in the topic is growing, and it is anticipated that further research will help to clarify the theory, diagnosis, and treatment options for patients with CGH. According to Frese A et al (2008) Upper cervical pain is frequent in different primary headaches and not sufficient evidence for cervicogenic headache (CGH). Biological markers should help to differentiate CGH from other headache disorders.
In most cases, imaging techniques of the cervical spine are not helpful for the diagnosis of CGH.
Symptoms and signs of neck involvement, such as a mechanical precipitation of attacks, a restriction in range of motion of the cervical spine, and the existence of ipsilateral neck, shoulder, or arm pain, seem to be reasonably valid for the diagnosis of CGH, but its reliability and validity should be confirmed in larger studies.
Positive diagnostic blockades of cervical structures or its nerve supply are not specific for CGH. Neurophysiological investigations give some insight into the pathophysiological mechanisms of CGH but are not diagnostic. In CGH, calcitonin gene-related peptide levels do not differ between the symptomatic and the asymptomatic side, between the jugular and the cubital blood, and between days with and without headache. There is no evidence for an activation of the trigeminovascular system in CGH. It can be concluded that CGH is not just a migraine variant triggered by neck dysfunction but a functional entity.
Until then, it is essential that clinicians maintain an open, cautious, and critical approach to the literature on cervicogenic headaches.

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