CERVICOGENIC HEADACHE IN UNDERGRADUATE STUDENTS AND ITS ASSOCIATION WITH FORWARD HEAD POSTURE, ACADEMIC STRESS, AND ANXIETY IN QUETTA, PAKISTAN

Abstract

Background: Cervicogenic headache (CGH) is a secondary headache associated with dysfunction of cervical structures. Forward head posture (FHP), prolonged digital-device use, and psychological stress may be relevant factors among university students, but their relationships are complex. Objective: To describe the occurrence and severity of cervicogenic-headache symptoms among undergraduate students in Quetta and examine their associations with FHP, stress, and anxiety.

Methods: A quantitative cross-sectional study was conducted among undergraduate students aged 18–30 years from three universities in Quetta. Convenience sampling was used. Data were collected using the Cervicogenic Headache Patient Questionnaire (CHPQ), the Depression Anxiety Stress Scales–21 (DASS-21), and a mobile posture-assessment application to estimate the craniovertebral angle (CVA). Data were analysed in SPSS using descriptive statistics, correlation analyses, and chi-square testing.

Results: The thesis records included 151 participants, while some analyses had 150 valid responses. CHPQ severity was mild in 47.7%, moderate in 14.6%, and severe in 37.1% of valid responses. Approximately 62% had abnormal FHP screening results. Pearson correlation between CHPQ severity and FHP was not significant (r = −0.044, p = 0.595). The association between CHPQ and stress/anxiety was weak; Pearson’s r was 0.156 (p = 0.057), while Spearman’s rho was 0.163 (p = 0.046). The chi-square association was borderline and not statistically significant at the 0.05 level (χ² = 15.052, df = 8, p = 0.058).

Conclusion: Headache symptoms and postural abnormalities were common in this sample, but the analyses did not demonstrate a significant relationship between FHP and CHPQ severity. The association between stress/anxiety and headache severity was weak and differed slightly according to the statistical test. Findings should be interpreted cautiously because of the cross-sectional design, convenience sampling, and inconsistencies in valid sample counts.