Association Between Stress and Cervicogenic Headache Among Young Adults in Karachi, Pakistan: A Cross-Sectional Analytical Study
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Abstract
Background: Cervicogenic headache is a secondary headache disorder linked with cervical musculoskeletal dysfunction, posture-related aggravation, and functional limitation. Young adults in urban settings may be vulnerable because of academic pressure, occupational demands, prolonged screen exposure, physical inactivity, and perceived stress. Objective: To determine the association between perceived stress and cervicogenic headache-related symptoms among young adults in Karachi, Pakistan, and to evaluate occupational and lifestyle predictors of cervicogenic headache. Methods: A cross-sectional analytical study was conducted among 150 adults aged 18–35 years residing in Karachi. Participants were recruited through convenience sampling from universities, offices, and public settings. Data were collected using a structured questionnaire assessing demographic and lifestyle factors, perceived stress using the PSS-10, and cervicogenic headache-related symptom indicators. Chi-square tests assessed bivariate associations, and binary logistic regression evaluated independent predictors. Results: More than half of participants reported cervicogenic headache-related symptoms, including frequent headaches (55.3%), headache starting from the neck and radiating (51.3%), associated neck pain (52.0%), posture- or movement-triggered headache (60.0%), and improvement with massage or physiotherapy (53.3%). Perceived stress was associated with headache presence in bivariate analysis (χ² = 14.514, p = 0.006), while inability to cope was also significant (χ² = 15.402, p = 0.004). Screen time was associated with posture-triggered headache (χ² = 21.321, p < 0.001). In regression analysis, occupation (OR = 2.346, p < 0.001) and physical activity (OR = 2.227, p = 0.003) were independent predictors, whereas PSS total score was not (OR = 1.004, p = 0.911). Conclusion: Cervicogenic headache-related symptoms were common among young adults in Karachi. Stress was associated with headache in bivariate analysis, but occupation and physical activity were stronger independent predictors, supporting integrated ergonomic, physical activity, and stress-management strategies
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