Headaches Flashcards
Cluster Demographic
Affect only 0.1 % of people
Men 5X more likely
Cluster symptoms
Unilateral, intense pain Intermittent pain (every few hours or intense pain several times in an hour) Often nocturnal
Cluster etiology
smoking is a risk factor
Association with abnormal hypothalamic function
Tension symptoms
Bilateral, diffuse, band pain around head
Dull or vice like
Onset later in the day
last 30 min to weeks
Mm stiffness, hypertoned mm, nausea, vertigo and tinnitus
Tension demographic
86% of women experience them 63% of men experience them
3 % of all people have them
These HA begin in adulthood
Tension etiology
Stress, poor ergonomics or posture, family history, trigger points in neck or head, cold, hypoglycemia, fatigue
Migraine symptoms
unilateral, starts as dull ache then becomes intense and pounding over a focal area
last 4-72 hours
may have aura
Migraine Demographic
25% of women 8% of men
Family history 70%
Migraine Etiology
Triggers: hunger, stress, allergies, meds, weather, visual/auditory olfactory stimuli, sleep, hormones
Trauma Symptoms
pain in the head or neck from injury
Demography of Trauma headache
As a result of trauma - anyone
Etiology of headache
Trauma to the head, neck or spine, falls on tailbone may create headache due to dural tube and meninges tension
Sinus sign and symptoms
Pain in forehead, maxilla, between eyes
Nasal drip or congestion
Facial tenderness
Demographics of sinus headache
Rare, only in 2% of people that get headaches
Etiology of Sinus headache
Viral, bacterial infections, allergies, history of facial trauma, abscesses in molars
Sign and symptoms of Rebound headache
Begin in early a.m. when blood levels of drug are lower
Throbbing pain
Bilateral pain
Demography of rebound headache
Anyone experiencing medication/drug withdrawal
Etiology of Rebound headache
Removal of caffeine, drugs or medications
Headache may be due to
inflammation
Muscle spasm
Vasodilation/vasoconstriction of blood vessels
Ischemia
Trigger points
Soft tissue and or nerve injury
Trauma
Pain referred from elsewhere (organ, etc)
point involvement (OA, joint compression, cervical subluxation etc)
underlying pathology (tumor, aneurysm, venous swelling)
Chemicals (internal or external)
Others: food, noise, lack of sleep, sugar, hyper tension, dehydration
Primary headaches
Cluster, migraine, tension headaches is the condition itself
Headache is as known as
Cephalalgia
What do you do to test nerve root or facet joint irritation
Cervical compression/distraction
Seated, stand beside the patient
Carefully apply compression downward on the patient’s head
How do you know compression test is positive for nerve root or joint facet
Radiating pain or other neurological signs in affected arm indicates compression of a cervical nerve root
Pain in the neck/shoulder indicates cervical facet joint irritation
how to apply Distraction test
Position seated
Grasp the patient’s head at occiput and temporal (or frontal) area - not on mandible
Apply slow traction, superiorly, maintain traction for at least 30 seconds
How do you know your distraction test is positive
Reduction of pain/signs and symptoms reduce, because of opening of the foramina, reduced pressure on facet joints, relieving muscle spasm
tests for cervical nerve root or facet joint irritation. You can identify one side at a time
Spurling’s /quadrant test
How to apply Spurling’s test
Unaffected side first
Seated, extend, side bend and rotate
Carefully apply compression down ward
How do you know Spurling’s /quadrant test is posive
Pain radiates down into the arm of that side
Tests for circulation deficiency of the vertebral artery at the trasverse foramen
Vertebral Artery Test (VAT)
How to apply Vertebral Artery Test (VAT)
Patient is spine, therapist seated by guest’s head
Patient has eyeglasses off (if applicable) asked to keep eyes open
Passively fully extend the head and neck, side flexion, then fully rotate to the same side, hold for 30 seconds
How do you know Vertebral Artery test is positive
Vertigo, nausea, nystagmus (rapid involuntary movement of the eyes), Malaise, Nausea, vomiting, Dizziness/vertigo, Unsteadiness in walking, incoordination, visual disturbances, severe headache, weakness in extremities, sensory changes in face or body, dysarthria (speech), dysphagia (swallowing) disorientation, light headedness, hearing difficulties, facial paralysis
How do you find out if the person has meningitis
Kernig’s Test/soto hall test
How to do Kernig’s/Soto Hall Test
Patient is supine on the table
ask the patient to place their hands behind their head and flex their chin to their chest
If the patient experiences a sharp pain down the posterior neck and spine this may indicate meningities
The type of vasculitis may coexist with polymylagia rheumatica, which is characterized by sudden onset of pain and stiffness in muscles (pelvis, shoulder) of the body and seen in the elderly (Women 70 years).
Temporal arteritis, inflammatory disease of blood vessels. Can be with RA, SLE.
Fever, headache, tenderness and sensitivity on the scalp, reduced visual acuity (blurred vision) acute visual loss. 76% canses invovling the eye. Medical emergency.
PHYSIOLOGICAL EFFECTS OF STRESS
Hypothalamus secretes a cortisol releasing factor, which stimulates pituitary gland to release adrenocorticotrophic hormone (ACTH) this hormone communicates to adrenal glands to release cortisol to adrenal glands to release cortisol and epinephrine.
What does Cortisol do
Glucose level, fat metabolism and influencing vascular flow and breathing
What does Epinephrine do
dilates blood vessels increases cellular metabolism and heart activity
How is reticular activating system activated?
through somatic, visual and auditory, cerebral cortex, hypothalamus and limbic system. Once activated, it activates Sympathetic nervous system. - Hypertonicity
What does diaphragmatic breathing promote
- relaxation by decreasing the effects of the nervous system
- relaxation of muscle contractions upon exhalation
- pain management
- relaxation by stimulating PNS
Hydorotherapy for tention HA
Hot bath or heat application to Trigger point
cool cloth to head during HA
Foot baths during HA
Vascular headaches hydrotherapy
No local heat as increased blood flow to the head makes worse
Migraine hydrotherapy
Herbal bath on foot, cold towel on neck and forehead
Icy foot bath to increase circulation of the foot (afterwards)
cold water and hot water wrist baths (when HA is coming on)
Hot full immersion baths if client feels cold before HA
Cluster headaches hydrotherapy
Alternating hot and cold showers to improve circulation
once a day for 2-3 months.
Cold compress relief by soaking a cloth with cold water for a few minutes, wringing it out and putting on the painful area
