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Diagnosis and Management of Facial Pain
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Rajiv K. Bhalla, Timothy J. Woolford
Cervicogenic headache is recognized as a referred pain in the head and by muscular association, to the face.40 Primary sensory afferents from the cervical roots C1 to C3 converge with afferents from the occiput and trigeminal afferents on the same second-order neuron in the upper cervical spine. Consequently, the anatomical structures innervated by the cervical roots C1 to C3 are potential sources of cervicogenic headache. Pain may originate from different muscles and ligaments of the neck, from intervertebral discs and particularly, from the atlanto-occipital, atlanto-axial, and C2/C3 zygapophyseal joints. Treatment may include simple analgesia, physiotherapy, complementary therapies such as acupuncture or massage, cervical epidural corticosteroid injection, local botulinum toxin injection, radiofrequency ablative therapy, and surgery. Severe cases should be managed in conjunction with a spine specialist.
Geriatric headache
Published in Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby, Headache in Clinical Practice, 2018
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby
Primary disorders of the cranial bones are rare. Abnormalities of the cervical spine have been reported to produce anterior or posterior head pain, perhaps by direct involvement of the cervical nerve roots or indirect involvement of the descending tract of the trigeminal nerve. The existence of cervicogenic headache as a distinct neurologic disorder is controversial. The IHS recognizes a narrowly defined disorder termed headache associated with disorder of the cervical spine’.9
The neck
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Cervicogenic headache is a referred pain syndrome, usually unilateral in distribution, originating from various cervical structures innervated by the upper three cervical spinal nerves. They can be the atlan-to-occipital joint, atlantoaxial joint, C2–3 facet joint, C2–3 intervertebral disc, myofascial trigger points and also the spinal nerves.
Musculoskeletal ultrasound imaging and clinical reasoning in the management of a patient with cervicogenic headache: a case report
Published in Physiotherapy Theory and Practice, 2021
Based on the regional interdependence relationship between the thoracic and cervical spine the patient underwent a nonspecific thrust manipulation of the upper thoracic spine. This concurs with the 2017 clinical practice guidelines indicating the possible benefit for patients with chronic cervicogenic headaches (Blanpied et al., 2017). Deep friction of the suboccipital muscles followed by tissue lengthening resulted in overall decreased muscle tone. After her initial manual therapy interventions, her headache decreased from 6/10 to 3/10 supporting the hypothesis that there was a cervical mechanical contribution to her headaches. This supports the classification of cervicogenic headache in this patient case. Active exercise to initiate deep neck flexor muscle activity was initiated and MSK US was utilized to provide biofeedback. Postural recommendations were included as part of the plan of care to increase awareness of the head/neck positional relationship. To maximize the carryover of manual therapy interventions the patient was instructed in an augmented exercise program, which included Mulligen’s headache self-mobilization with movement targeting C1-C2 utilizing a cord (Blanpied et al., 2017).
Craniopharyngioma in a young woman with symptoms presenting as mechanical neck pain associated with cervicogenic headache: a case report
Published in Physiotherapy Theory and Practice, 2021
Firas Mourad, Fabio Cataldi, Alberto Patuzzo, Sara Tunnera, James Dunning, César Fernández-de-las-Peñas, Filippo Maselli
Notably, the individual was previously successfully treated for the diagnosis of cervicogenic headache with a complete symptom resolution following several physiotherapy sessions. Nevertheless, and subsequently, the patient becomes concerned because the frontal headache pain intensity was rapidly worsening. The patient admitted controlling symptoms with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain medication (i.e., paracetamol).
Intra- and inter-rater reliability of movement and palpation tests in patients with neck pain: A systematic review
Published in Physiotherapy Theory and Practice, 2018
Anders Jonsson, Eva Rasmussen-Barr
All but one of the studies included subjects with ongoing mechanical neck pain or neck pain described in terms referring to nonspecific neck pain conditions. One study considered subjects with cervicogenic headache the previous 72 hours in addition to neck pain (Hanten et al., 2002).