• An evidence-based clinical practice guideline for the non-pharmacological management of tension-type and cervicogenic headaches

Target population:

  • Adults (aged 18 years and older) with tension-type headaches (episodic or chronic) and cervicogenic headaches 4-6 months duration

Tension-type headaches:

  • Tension-type headaches (frequent episodic or chronic) are defined as being typically bilateral, pressing or tightening in quality and of mild to moderate intensity, lasting minutes to days or unremitting on average for at least three months. ¹ The pain does not worsen with routine physical activity and is not or may be associated with nausea, though photophobia or phonophobia may be present. It can be associated with pericranial tenderness on manual palpation of the head and neck muscles. ² ³ ⁴

Cervicogenic headaches:

  • Cervicogenic headaches are caused by a disorder of the cervical spine (bony, disc and/or soft-tissue structures) and are usually accompanied by neck pain. ¹ ⁵ ⁶


  • Non-pharmacological 


Target users:

  • Healthcare providers (e.g., medical doctors, physiotherapists, nurse practitioners, chiropractors, psychologists, and massage therapists) caring for patients with non-specific low back pain in primary, secondary, and tertiary health care settings


¹Headache Classification Subcommittee of the International Headache Society (2018). Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 38(1), 1–211.

²Fernandez‐de‐las‐Penas, C., Alonso‐Blanco, C., San‐Roman, J., & Miangolarra‐Page, J. C. (2006). Methodological quality of randomized controlled trials of spinal manipulation and mobilization in tension‐type headache, migraine, and cervicogenic headache. Journal of Orthopaedic and Sports Physical Therapy, 36(3), 160–169.

³Fernandez‐de‐Las‐Penas, C., Cuadrado, M. L., & Pareja, J. A. (2007). Myofascial trigger points, neck mobility, and forward head posture in episodic tension‐type headache. Headache, 47(5), 662–672.

⁴Sohn, J. H., Choi, H. C., Lee, S. M., & Jun, A. Y. (2010). Differences in cervical musculoskeletal impairment between episodic and chronic tension‐type headache. Cephalalgia, 30(12), 1514–1523.

⁵Sjaastad, O., & Bakketeig, L. S. (2008). Prevalence of cervicogenic headache: Vaga study of headache epidemiology. Acta Neurologica Scandinavica, 117(3), 173–180.

⁶Sjaastad, O., Fredriksen, T. A., & Pfaffenrath, V. (1998). Cervicogenic headache: Diagnostic criteria. The Cervicogenic Headache International Study Group. Headache, 38(6), 442–445.