Effect of Myofascial Release Technique Alone or Combined With Exercises on Cervical Cobb Angle, Sleep Quality, and Psychological Factors in Patients With Cervicogenic Headache

This study will investigate whether myofascial release therapy alone or in combination with therapeutic exercises can improve cervical spine alignment, measured by cervical Cobb angle on X-ray, in patients with cervicogenic headache. The research will also examine potential effects on sleep quality and psychological factors."

Inclusion Criteria: * Age 20-55 years. * Clinical diagnosis of cervicogenic headache according to International Classification of Headache Disorders (ICHD-3) criteria (headache attributed to cervical disorder). Exclusion Criteria: * History of major cervical spine pathology such as fracture, dislocation, congenital malformation, tumor, infection, or inflammatory arthritis (e.g., rheumatoid arthritis, ankylosing spondylitis). * Previous cervical spine surgery or fusion at any level. * Red flag symptoms indicating serious pathology (e.g., progressive neurological deficit, unexplained weight loss, fever, history of cancer). * Systemic or neurological disorders that may affect neck function or headache (e.g., multiple sclerosis, Parkinson's disease). * Severe osteoporosis or metabolic bone disease that contraindicates cervical X-ray imaging. * Vascular disorders such as vertebrobasilar insufficiency or carotid artery disease. * Pregnancy or breastfeeding (due to radiation exposure during cervical radiography). * Unstable psychiatric conditions (e.g., severe depression, psychosis) that may interfere with participation or adherence. * Recent physiotherapy or manual therapy targeting the cervical region within the past 6 weeks, or planned during the study outside the protocol. * Use of botulinum toxin or steroid injections to the neck or head region in the past 6 months. * Contraindications to manual therapy or exercise (e.g., acute cervical disc herniation, severe myelopathy, unstable cardiovascular disease). * Inability to understand study procedures, comply with treatment sessions, or provide informed consent. * Symptoms of migraine, tension-type headache (TTH), or any other headache apart from cervicogenic headache.