Tension Headaches and TMJ Flashcards

1
Q

what is the differential diagnosis of primary headaches

A

tension headaches (most common)
migraine
medication overuse
cluster headache/trigeminal cephalgias

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2
Q

worst headache of their life

A

Subarachnoid Hemorrhage= emergency

secondary headache

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3
Q

headache + new focal neurologic weakness

A

stroke (emergency)

secondary headache

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4
Q

onset of headache at greater than 50 years old

A

neoplasm, temporal arteritis

secondary headache

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5
Q

headache + associated systemic symptoms

A

meningitis, encephalitis (emergency)

secondary headache

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6
Q

headache + acute eye pain

A

acute angle glaucoma (emergency)

secondary headache

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7
Q

high blood pressure + headache

A

hypertensice urgenct/emergency or preeclampsia

secondary headache

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8
Q

the most difficult diagnosis to figure out is the _ diagnosis

A

secondary

chief complaints come from multiple etiologies and require multiple treatments (lifestyle modifications are one of them)

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9
Q

what is the pain pattern of tension type headaches

A

bilateral tight/achy pain/band like

radiates from occipital/cervical region

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10
Q

what are the subcategories of tension headaches

A

infrequent < 1 day a month
frequency 1-15 days a month
chronic > 15 days a month

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11
Q

associated symptoms with tension headaches

A

usually none

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12
Q

most cases of tension headaches originate from?

A

the cervogenic trigeminal nerve complex

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13
Q

most common causes of tension headaches (3)

A

myofascial pain referral
cervical facet referral
TMJ dysfunction

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14
Q

what is myofascial pain refferal

A

this can be influence from cervical, cranial , or trigger point dysfunction that cause tension headaches

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15
Q

what is a trigger point

A

this is a dyfunctional muscle that is mapped out and has a focal/discretevery sensitive predictable location with predictable referral patterns

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16
Q

trigger points are usually causes by?

A

traum, chronic pain/strain, overuse and sedentary lifestyles

17
Q

what are the associated symptoms of trigger points

A

a taut band of muscle that has a palpable nodule/knot; upon palpation there is reproduction of pain and a. twitch response (muscle spasm)

18
Q

what is the difference between trigger point and a tender point

A

trigger points have a characteristic pain pattern, located only in the muscle, radiating pain, in a tuat band of tissue, and has a twitch response with palpation

tenderpoints- no characteristic pain patter, located in tendons, ligaments, fasica, and muscle. no radiating pattern and no taut band/twitch respone

totally different

19
Q

what is the treatment of myofasical pain referral

A

conservative therapy first: manual manipulation with ischemic compression (ST)
- physical therapy
- spray and stretch
- dry needling

injections into trigger point, medication

20
Q

where is the cervical fact joints located

A

they are posterior lateral between cervical vertebra

21
Q

how does cervical facet referal cause tension headaches

A

the joint capsule will result in facet pain that refers up to the head

(its a referral pattern)

22
Q

what causes cervical facet referral

A

degeneration/arthritis, overuse/poor posture

23
Q

associated symptoms of cervical facet referral pain

A

palpation of facet joint is paiful or gives a headache

protective muscle spasms that results in a painful loss in ROM

24
Q

how do we treat cervical facet referral pain?

A

Conservative treatment first: RICE, manual medicine (OMM), physical therapy

meds, injections guided by fluoroscopy or radiofrequency ablation to burn out nerve innervation of facet (this is for more chronic cases)

25
what is the normal physiology of the TMJ
the mouth opens at the condylar hinges and the disc should slide foward with anterior glide the muscles will control the jaw position
26
what are some pathologies associated with the tmj giving TMJD
trauma (joint degeneration) disc displacement improper loading of innervated structures (muscle overuse)
27
tension headache due to TMJD is primarily due to?
internal : malocculsion and bruxism (grinding teeth) external: trauma joint displacement/disc dislocation ( opening mouth a lot) reffered cervical and cranial muscle pain
28
what are the types of pain associated with TMJD
myofascial pain from gaurding joint capsule pain from dislocation ( reducing vs non-reducing)
29
associated symptoms of TMJD
decreased jaw ROM creptius of joint (pop when joint displacing/reducing) pain with chewing, closing/opening mouth jaw deviation pain in morning due to grinding teeth at night
30
what are the treatments for TMJD
TMJD specific- bite splint, stretching, CBT conservative mannual medicine! (treatments are in the lab) physical therapy, medications, injections if there is an associated trigger point
31
_ is contraindicated in TMJD
SURGERY