HA (16) Flashcards
3 types of primary HA
-migraine
-tension type
-trigeminal autonomic cephalgia (cluster HA)
Secondary HA
Cervicogenic
3 risk factors for migraine
-begins at puberty
- 35-45 yo
-W > M
5-ish characteristics/s/s of migraine attack
-nausea
-photophobia
-phonophobia
-exacerbation by PA
-1 sided
-recurrent, pulsating
3 triggers of migraine
Stress
Certain foods
Menses
S/s of migraine with aura
-visual zigzags, flashes
-less than 30 min symps
4 PT interventions for migraine
-trigger pt release
-address postural dysfxn
-relax techniques
-trigger avoidance
Most common primary HA
Tension type
Two types of tension type HA? Briefly describe
Episodic: < 15 days/month
Chronic: > 15 days/month
MOI of tension type HA
Mus tension in neck, scalp, or face d/t stress, poor posture, overuse
4 risk factors of tension type HA
-W > M
-eye strain
-starts in teens
-irregular sleep pattern
4 characteristics of tension type HA
-pressure/tightness
-bandlike pressing
-bilateral
-dull, no throbbing
5 PT interventions
-post re-ed
-ergonomic adjustments
-stress mgt
-STM
-stx and strengthen neck and upper back
Cause of cluster HA? What type of pain?
-activation of trigeminal-autonomic reflex
-severe unilateral pain
Prevalence rate of cluster HA? Who most affected
-uncommon, < 1 in 1000
-6 M : 1 W
4 risk factors of cluster HA
-develops in 20s, avg 30
-smoking
-alc
-high altitude exposure
5 s/s of cluster HA
-severe brief symps
-UNILATERAL
-burning or neuralgic pain
-less than 3 hours
-periorbital, frontal, temporal
ANS symps of cluster HA
-ipsilateral lacrimation
-rhinorrhea
-partial Horner syndrome
-mitosis
-ptosis
4 PT interventions for cluster HA
-meds
-stress mgt
-manual and post re-ed
Most common second degree HA
Med overuse
3 tx for med overuse HA
-meds
-lifestyle mod
-pt edu
What is a cervicogenic HA
Unilateral pain that starts in neck
-common chronic and recurrent HA starts after neck mvmnt
3 dx criteria for cervicogenic HA
-source of pain in neck and felt in head or face
-evidence pain from neck
-pain resolves within 3 months after successful tx
What type of mus tenderness involved with cervicogenic HA
Pericranial mus
4 traumatic risk factors for cervicogenic HA
-neck trauma
-WAD
-strain
-chronic spasm
4 non-traumatic risk factors for cervicogenic HA
-DDD
-DJD
-poor posture
-mus imbalance
How to diff dx cervicogenic from migraine
Doesn’t respond to meds
How to diff dx cervicogenic from migraine and TTHA
Unilateral pain w/o side shift
2 major ways to diff dx cervicogenic HA
-no specific patho on imaging
-HA w/ neck movements
How does forward head posture affect cervicogenic HA
-hyperext of upper c/s
-facet dysfxn causes gradual FH
-upper c/s ext compress craniocervical structures (greater and lesser nerves)
How can manip help cervicogenic HA
Stimulate inhibitory systems in SC to activate inhibitory pathways
4 PT interventions for cervicogenic HA
-A/PROM
-mobs and manip (c/s and t/s)
-deep cervical flexor and extensor, scap stab strengthening
-post re-ed
5 expected exam findings cervicogenic CPGs
+ cervical flex rot test
HA reproduced w/ provocation of involved upper segs
Limited ROM
Restricted upper cervical seg mob
Decreased strength, endurance, coordination in mus
Cervicogenic acute tx
C1-2 self SNAG
Cervicogenic subacute tx
Manip and mob, C1-2 self SNAG
Cervicogenic chronic tx
-cervical and/or thoracic manip
-ex for cervical and scapulothoracic region
-manual and ex
3 HA screening rules outs w/ acute traumatic conditions
-fx
-dislocations
-gross instab
5 HA screening rule outs W/ non traumatic pain
-tumor
-inflam disorder
-infect
-visceral referral
-VBI/CAI
