As early as 1983,Sjaastad proposed the concept of cervicogenic headache(CH)in the World Headache Conference,that is,the pain from upper cervical joints and muscles can be referred to the head.CH is a group of syndromes mainly caused by dysfunction of the upper cervical spine and its component muscles,ligaments,bony,vertebral arteries and/or soft tissue elements,usually not accompanied by neck pain.Therefore,the treatment strategy of CH focuses on pain relief and repair cervical lesions.Patients with painful disorders of upper cervical zygapophysial joints showed significant headache reliefafterdirectly treated atdisordered cervical joints[1].

The following therapeutic methods are used in the treatmentofthe CH,including medicaltherapy,acupuncture,nerve root block,physical therapy,massage,kinezitherapy,traction,surgical treatment,etc[2].The optimal treatment of CH is still under investigation and it seems thatthe bestresults are achieved by a comprehensive treatment.

CH falls in the category of Bizheng in the theory of traditional Chinese medicine.Early in Qin and Han Dynasties of China(the third century B.C.),Huangdi Neijingrecorded the principles and methods of acupuncture in the treatment of Bizheng.That is to say,according to the location of Bizheng,the corresponding viscera acupoints are taken for acupuncture.There are also clinical reports that the efficacy of acupuncture method at cervical Jiaji(EX-B 2)is superior to that of conventional acupuncture for CH[3].And acupuncture can strengthen the therapeutic effect of simple cervical paravertebral block in relieving headache and improving cervical vertebral activity in CH patients[4].However,more high quality clinical research about the acupuncture in the CH management are needed to better guide the clinic.

Here a randomized,single-blind,multi-center,parallel controlled clinical trial was performed to observe the clinical efficacy and safety of a three-step acupuncture and cupping therapy for CH.It suggests that acupuncture is proven to be effective as an alternative therapy in treating and strengthen the therapeutic effect of other therapeutic methods in the CH management.To read more about this acupuncture therapy,see this artical please: Link:https://www.tmrjournals.com/tmr/EN/10.12032/TMR201 915097

Xiong-Zhi Wu

Editor-in-Chief of TMR

1. Becker WJ.Cervicogenic headache:evidence that the neck is a pain generator.Headache 2010,50:699-705.

2. Grgi? V.Cervicogenic headache:etiopathogenesis,characteristics, diagnosis, differential diagnosis and therapy.Lijec Vjesn 2007,129:230-236.

3. Chu H,Hu B.Triple acupuncture method at cervical Jiaji(EX-B 2)forcervicogenic headache:a randomized controlled trial.Zhongguo Zhen Jiu 2016,36:29-32.

4. Wu JX,Fan RJ,Song WX,et al.Effect of cervical paravertebral block combined with acupuncture intervention on cervicogenic headache.Zhen Ci Yan Jiu 2013,38:411-414.