Headaches Flashcards
What else are headaches known as?
cephalalgia
define headache
pain or ache in the head
What are the types of headaches?
- tension
- migraine
- cluster
- organic
- rebound
- TMJ
- exertion
- allergy
- eye strain
- temporal arteritis
- sinus
What is a primary headache?
when the headache is the condition itself
What is a secondary headache?
when an underlying pathology causes the headache
Which is more serious, primary headaches or secondary?
Secondary
What is the most important question to ask regarding headaches?
“Do you have a headache right now?”
What does a cervical compression/distraction test for?
nerve root or facet joint irritation
What does a spurling’s test/Quadrant test for?
cervical nerve root, facet joint irritation
What does a VAT test for?
circulation deficiency of the vertebral artery at the transverse foramen
What does Kernig’s and Soto Hall test do?
puts stress on the meninges
What are the symptoms for a cluster headache?
- unilateral px
- intense px
- intermittent px
- (every few hours or intense px several times in an hour)
- often nocturnal
What is the demographic for a cluster headache?
- affects only 0.1% of people
- men 5x more likely
What is the etiology of a cluster headache?
- smoking is a risk factor
- association with abnormal hypothalamic function
What are the symptoms for a tension headache?
- bilateral px
- diffuse px
- band like px around head
- dull or vice like
- onset later in day
- last 30 min-weeks
- mm stiffness, hypertoned mm, nausea, vertigo and tinnitus
What is the demographic for tension headaches?
- 86% of women experience them
- 63% of men experience them
- 3% of all people have them
- begin in adulthood
What is the etiology for tension headaches?
-stress, poor ergonomics or posture, family hx, trp in neck or head, cold, hypoglycemia, fatigue
What are the symptoms for migraine headaches?
- unilateral
- px starts as dull ache then becomes intense and pounding over a focal area
- last 4-72 hours
- may have aura
- nausea, vomiting, photophobia, phonophobia
What is the demographic for migraine headaches?
- 25% of women and 8% of men
- family hx 70%
What is the etiology for migraine headaches?
triggers: hunger, stress, allergies, meds, weather, visual/auditory/olfactory stimuli, sleep, hormones
What are the symptoms for trauma headaches?
-pain in the head or neck from injury
What is the demographic for trauma headaches?
anyone
What is the etiology for trauma headaches?
- trauma to the head, neck, or spine.
- falls on tailbone may create headache due to dural tube and meninges tension
What are the symptoms for sinus headaches?
- px in forehead, maxilla, b/w eyes
- nasal drip or congestion
- pain increases in different positions
- facial tenderness
What is the demographic for sinus headaches?
- rare
- only in 2% of people that get headaches
What is the etiology for sinus headaches?
-viral, bacterial infections, allergies, hx of facial trauma, abscesses in molars
What are the symptoms of a rebound headache?
- begin in early AM when blood levels of drug are lower
- throbbing px
- bilateral px
What is the demographic for rebound headaches?
anyone experiencing med/drug withdrawal
What is the etiology of a rebound headache?
-removal of caffeine, drugs or medications
Which types of headaches are primary headaches?
cluster, tension, and migraine
Which types of headaches are secondary headaches?
trauma, sinus, and rebound
What are the red flags to tx?
- severe px that comes on suddenly
- head px accompanied by fever, nausea, and vomiting
- head pain that worsens over time, especially if it follows a head injury
- accompanied by mental confusion, seizures, mood swings, or other neurological symptoms (memory loss, double vision, loss of motor control/coordination/strength, affects special senses)
- HA that occurs after physical activity, straining or coughing
- first appears after the age of 55 or in early childhood
- HA’s that affect breathing
- HA’s accompanied by px or numbness on one side
- HA’s accompanied by clear fluid or blood coming out of ears or nose
- HA’s that do not fit a recognizable pattern of S&S to the person
- new HA in a person with a history of cancer or heart diesase
What hydrotherapy would you give for homecare for tension headaches?
- hot bath or heat application to trp if not on head during headache or in between
- cool cloth to head during headache
- foot baths during headaches
What hydrotherapy would you give for homecare for vascular headaches?
-AVOID local heat
What hydrotherapy would you give for homecare for migraine headaches?
- herbal foot baths
- icy foot bath
- contrast wrist baths
- hot full immersion baths if the client feels cold used before the migraine starts at onset of headache.
What hydrotherapy would you give for homecare for cluster headaches?
- herbal foot baths
- alternating hot and cold showers
- cold compress relief
What is the positioning for a cervical compression test?
- client seated; stand behind
- apply compression downward on the patient’s head
- hold for 10 seconds
What is a positive cervical compression test?
- 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
What is the positioning for a cervical distraction test?
- client is seated; stand behind
- grasp the patient’s head at occiput and temporal areas
- apply slow traction, superiorly, maintain traction for at least 10 seconds
What is a positive cervical distraction test?
reduction of pain/signs and symptoms reduce; because of opening of the foramina, reduced pressure on facet joints, relieving muscle spasm
What is the positioning for a spurling’s test?
- Test unaffected side first!
- client seated; side bend, rotate & extend the neck
- carefully apply compression downward on exhale
- testing the side you are turning towards ie. left rotation = left side test
- repeat on other side
What is a positive spurling’s test?
-pain radiates down into the arm on that side.
What is a Reverse Spurling’s?
-causes muscle spasm on opposite side
What is the positioning for a vertebral artery test?
- patient is supine or seated; therapist seated by guest’s head
- patient has glasses off (if applicable); asked to keep eyes open
- actively fully extends the head and neck, side flexion, the ipsilateral rotation
- hold for 30 seconds
- repeat on other side
- testing the opposite side
What is a positive vertebral artery test?
- vertigo, nausea, nystagmus
- do not perform further testing if positive.
- not a medical emergency
What is the positioning for a 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
What is a positive for a soto hall test?
- if the patient experiences a sharp pain down the posterior neck and spine
- may indicate meningitis
What is the positioning for a Kernig’s test?
- patient is supine
- passively flex the hip & knee
What is a positive for a Kernig’s test?
- pain in the spine.
- “zing down spinal cord”
