Objective: To evaluate the effect of neck-specific exercise (NSE) compared to prescribed physical activity (PPA) on headache and dizziness in individuals with cervical radiculopathy (CR). Also, to investigate associations between headache or dizziness and pain, neck muscle endurance (NME), neck mobility, physical activity, and fear avoidance beliefs.Methods: Individuals randomized to either NSE or PPA were selected to a headache subgroup (n = 59) and/or a dizziness subgroup (n = 73). Data were evaluated, according to headache and/or dizziness outcomes at baseline and at 3, 6, and 12-month follow-ups.Results: No significant between-group differences were found between NSE and PPA in either subgroup. In the headache subgroup, significant within-group improvements were seen at all follow-ups for NSE (p < .001) and from baseline to 3 (p = .037) and 12 (p = .003) months for PPA. For dizziness, significant within-group improvements were seen from baseline to 3 months for NSE (p = .021) and from baseline to 3 (p = .001) and 6 (p = .044) months for PPA. Multiple regression models showed significant associations at baseline between headache intensity and neck pain (adjusted R-square = 0.35, p < .001), and for dizziness with neck pain and dorsal NME (adjusted R-square = 0.34, p < .001).Conclusion: NSE and PPA show similar improvements in headache intensity and dizziness in individuals with CR. Headache intensity is associated with neck pain, and dizziness with neck pain and dorsal NME, highlighting the importance of these factors when evaluating headache and dizziness.

OBJECTIVE Approximately 50% of all individuals with cervical radiculopathy (CR) have headache, but knowledge on neck-related disability, headache, and pain aoof this study was to investigate and compare outcomes of ACDF and PCF regarding neck-related disability, headache, and neck and arm pain in individuals with CR and neck-related headache. METHODS This was a registry-based cohort study with prospectively collected data, including 2-year follow-up, using data from the Swedish Spine Registry (Swespine). All individuals with CR and neck-related headache registered in Swespine who underwent either ACDF (n = 2441) or PCF (n = 448) between January 2014 and March 2021 were included. Outcome measures were neck-related disability as measured by the Neck Disability Index (NDI), headache measured by the headache item of the NDI, and neck and arm pain intensity measured on an 11-point numeric rating scale. Patient-reported data were collected preoperatively and at 1- and 2-year follow-up evaluations. Surgeon-reported data regarding the operation were collected soon after the operation. Between- and within-group differences were analyzed for ACDF and PCF using a linear mixed model. RESULTS Headache decreased to a greater extent preoperatively by the 2-year follow-up evaluation with PCF than with ACDF (p = 0.021). No other significant between-group differences were found at any follow-up. For all outcome measures, there were significant within-group improvements from preoperatively to both the 1- and 2-year follow-up evaluations after ACDF and PCF (p < 0.001). CONCLUSIONS ACDF and PCF decreased headache in individuals with CR and neck-related headache, but PCF appeared to decrease headache more over time. Both interventions also resulted in similar improvements in neck-related disability and neck and arm pain.

Study Design. A prospective randomized multicenter trial. Objective. To investigate the effects of surgery with either structured postoperative physiotherapy or standard postoperative approach on neck-related headache in patients with cervical radiculopathy. Secondary, to investigate associations between change in neck-related headache and change in neck muscle endurance, neck mobility, or neck pain. Summary of Background Data. The effect of physiotherapy on individuals with neck-related headache after surgery for cervical radiculopathy due to magnetic resonance imaging-verified disc disease is unknown. Methods. One hundred six patients with neck-related headache and participating in a randomized controlled trial evaluating the additional effects of physiotherapy after surgery for cervical radiculopathy were included. Patients were randomized preoperatively to structured postoperative physiotherapy (n = 51) or the standard postoperative approach (n = 55). Outcome measures were headache intensity and neck pain intensity, neck muscle endurance, and neck mobility. Measures were obtained preoperatively and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Results. Headache intensity significantly changed from baseline to 1 year postoperatively (P < 0.001) in both groups.Post-hoctests showed a significant difference between baseline and 6 weeks (P <= 0.05). No significant differences were found between groups (P > 0.05) or between-group differences in changes over time (P > 0.05). The change in current headache intensity over time was associated with a change in current neck pain intensity over time (P = 0.003, beta = 0.40). Conclusion. There was a significant improvement in headache intensity 1 year postoperatively in patients with cervical radiculopathy and neck-related headache, but there were no differences between groups over time. Change in current headache intensity was only associated with a change in current neck pain intensity.