Cervicogenic Headache, Smartphone Addiction
Conditions
Keywords
Headache Impact, Neck Disability, Anxiety and Depression, Sleep Disturbance, Quality of Life, Smartphone Use
Brief summary
Cervicogenic headache is a secondary headache disorder that originates from the cervical spine and often presents with pain radiating from the neck to the head, reduced functional capacity, and impaired quality of life. In modern society, prolonged smartphone use and dependence are increasingly recognized as potential contributors to musculoskeletal problems, poor posture, psychological distress, and sleep disturbances. This study was designed as a case-control investigation to explore the relationship between smartphone addiction (problematic smartphone use) and clinical characteristics of cervicogenic headache in comparison with healthy individuals. Participants were evaluated in the outpatient clinics of Physical Medicine and Rehabilitation and Neurology at Yozgat Bozok University. A structured sociodemographic form was administered, and each participant completed a set of validated assessment tools. Smartphone use behavior was assessed with the Smartphone Addiction Scale-Short Form. Headache-related disability was measured with the Headache Impact Test. Cervical function was evaluated with the Neck Disability Index. Psychological status was assessed using the Hospital Anxiety and Depression Scale. Sleep quality was examined with the Jenkins Sleep Scale. Health-related quality of life was measured using the 12-item Short Form Health Survey, and pain intensity was evaluated with the Visual Analog Scale. The study was conducted in accordance with the Declaration of Helsinki. Approval was obtained from the Clinical Research Ethics Committee, and written informed consent was provided by all participants prior to enrollment.
Detailed description
Cervicogenic headache is a secondary headache that arises from dysfunction or pathology of the cervical spine and associated structures. It is characterized by unilateral head and neck pain, which may radiate to the frontal or temporal regions and is often aggravated by neck movements. Cervicogenic headache is known to cause substantial functional disability, emotional distress, and reduced quality of life. With the rapid increase in smartphone use worldwide, attention has been drawn to its possible musculoskeletal and psychological consequences. Prolonged forward head posture, repetitive neck movements, and excessive screen time may contribute to cervical dysfunction and exacerbate symptoms of cervicogenic headache. In addition, behavioral dependence on smartphones has been associated with mood disorders, sleep disturbances, and impaired daily functioning. Understanding the potential role of smartphone addiction as a modifiable factor in cervicogenic headache is therefore of clinical importance. The present study was designed as a case-control observational protocol to investigate the association between smartphone addiction and clinical outcomes in individuals with cervicogenic headache compared with healthy controls. Data were collected in the outpatient clinics of Physical Medicine and Rehabilitation and Neurology at Yozgat Bozok University. A standardized sociodemographic form was administered, followed by a comprehensive set of validated assessment instruments. These included the Smartphone Addiction Scale-Short Form to evaluate problematic smartphone use, the Headache Impact Test to measure the burden of headaches on daily life, the Neck Disability Index to assess functional limitations related to cervical spine disorders, the Hospital Anxiety and Depression Scale to screen for symptoms of anxiety and depression, the Jenkins Sleep Scale to evaluate sleep quality and disturbances, the 12-item Short Form Health Survey to assess physical and mental aspects of health-related quality of life, and the Visual Analog Scale to record the intensity of pain. All assessments were performed face-to-face by trained professionals in a clinical setting. The study protocol was approved by the Clinical Research Ethics Committee. Written informed consent was obtained from each participant before enrollment, and all procedures were carried out in accordance with the principles of the Declaration of Helsinki.
Interventions
None listed
Sponsors
Gulseren Demir Karakilic
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Adults aged 18-65 years Literate and cognitively capable of completing questionnaires Willing to participate and provide written informed consent For the patient group: Diagnosis of cervicogenic headache based on the International Classification of Headache Disorders, third edition, confirmed by a neurologist For the control group: Healthy volunteers with no known medical conditions or active complaints, age- and sex-matched with patients
Exclusion criteria
Comorbidities that may affect pain perception or mood, including diabetes mellitus, thyroid dysfunction, malignancy, chronic kidney disease, neurological diseases associated with neuropathic pain, rheumatoid arthritis, ankylosing spondylitis, or fibromyalgia Illiteracy or impaired communication Current use of medications that may interfere with outcome measures Withdrawal of consent at any stage
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Smartphone Addiction Scale - Short Form | At baseline | Ten-item self-report questionnaire scored on a six-point Likert scale ranging from 1 to 6. The total score ranges from 10 to 60, with higher scores indicating a greater risk of smartphone addiction. Sex-specific cut-off values are 31 or higher for males and 33 or higher for females. A Turkish validated version is available. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Headache Impact Test with 6 items | At baseline | Patient-reported questionnaire assessing the impact of headache on pain, vitality, role limitations, and emotional function. Each of the six items is scored from 6 to 13, producing a total score between 36 and 78. Higher scores indicate a greater negative impact of headache. A Turkish validated version is available. |
| Neck Disability Index | At baseline | Self-reported questionnaire with ten items scored from 0 to 5. The total score is converted into a percentage ranging from 0 to 100 percent. Higher percentages indicate greater disability related to neck pain. A Turkish validated version is available. |
| Hospital Anxiety and Depression Scale | At baseline | Fourteen-item questionnaire with two subscales assessing anxiety and depression, each scored from 0 to 21. Higher scores indicate more severe symptoms. Cut-off scores are defined as 0 to 7 for normal, 8 to 10 for mild, 11 to 14 for moderate, and 15 to 21 for severe symptoms. A Turkish validated version is available. |
| Jenkins Sleep Scale | At baseline | Four-item questionnaire assessing sleep quality and sleep disturbances. The total score ranges from 0 to 20, with higher scores indicating poorer sleep quality. A score greater than 15 indicates clinically relevant poor sleep. A Turkish validated version is available. |
| Short Form-12 Health Survey | At baseline | Twelve-item questionnaire assessing physical and mental components of health-related quality of life. It provides physical and mental component scores scaled from 0 to 100, with higher scores indicating better perceived quality of life. A Turkish validated version is available |
Countries
Turkey (Türkiye)
Outcome results
None listed