Inclusion criteria:
Male and female participants
participants of ages between 20-40 years
participants with primary complaint of headache
Frequency of at least once a week from minimum of last 3 months and Minimum Neck Disability Index (NDI) disability score of 20 % or greater
participants eligible after being diagnosed cervicogenic headache using revised diagnostic criteria established by the Cervicogenic Headache International Study Group (CHISG)
joint tenderness exhibited in at least one of the three upper cervical joints (C0-C3) on assessing through manual palpation
non-throbbing
non-lancinating pain of moderate to severe intensity were included into the study.
Exclusion criteria:
Participants having any other primary headaches e.g. migraine or tension headaches
presence of contraindications to cervical spinal manipulation like tumor, pregnancy, rheumatoid arthritis, fracture, metabolic diseases, infection, dislocation, osteoporosis
anticoagulant user, chronic corticosteroid user
previous 3 months history of head or neck surgery
previous history of a whiplash injury within six weeks
bilateral headaches
cervical spine stenosis
bilateral upper limb symptoms
presence of any signs showing central nervous system (CNS) involvement, presence of 2 or more nerve root compression signs, exhibiting “5 D’s” & “3 N’s