Cervicogenic Headaches (2) Flashcards
What are the characteristics of a migraine?
One sided
Throbbing
Light/sound sensitivity
What are characteristics of a tension headache?
Bilateral pressure
Longer duration
Dull
What are characteristics of a cluster headache?
One sided (localized)
Short duration
Sharp
What percentage of chronic headaches are cervicogenic?
14-18%
What percentage of recurrent headaches are cervicogenic?
15-20%
What is the trigeminocervical nucleus?
Afferents from CN 5 and C1-C3 (nuclei of the head, throat, and neck)
How does the trigeminocervical nucleus play a role in cervicogenic headaches?
C1-C3 all synapse at the same place so when there is a problem with one of them the brain may not be able to identify where the pain is coming from resulting in a cervicogenic headache
What will you hear subjectively in cervicogenic headaches?
Unilateral pain
Starts in back or head and spreads forward
Aggravated by prolonged static WB postures (sitting all day)
How can you test for a cervicogenic headache?
Reduced cervical ROM
Cranio cervical flexion test
Strength and endurance deficits in neck muscles
C0-C2 PA spring reproduces symptoms
Cervical flexion rotation test (32°)
What is the treatment for cervicogenic headaches?
C1-2 self snags
Cervical manipulations
What is the NNT for cervical manipulation in cervicogenic headache patients?
2.4
What are signs that the joint is the problem?
Positive cervical flexion rotation test
PA is restricted and reproduces symptoms
Limited cervical AROM
Manipulation feels crisp
What are signs that the problem is a Myofascial structure?
Negative cervical flexion rotation test
Palpation of muscles reproduces headache
Stress
Manipulation feels boggy
How do you perform the neck flexor muscle endurance test?
Tuck chin and hold head up (38 sec is normal)
