Headaches?a headache to differentially diagnose!

Reference:Vincent MB, Luna RA 1999 cerviogenic headache: a comparison with migraine and tension type headache. Cephalgia 19 (25);11-16

A quote from Prof. G. Jull of University of Queensland, Australia was:
?The single most important factor which determines the potential effectiveness of Physical Therapy treatment for headaches, is accurately diagnosing if the patient actually suffers from cervical headaches.?

This study concluded that cervical headache could be differentiated from migraine or tension headache with 100% sensitivity, IF 7 criteria were present. The most important / sensitive signs for cervical headache include:

1) Unilateral headache with side consistency
e.g. if a patient reports one day my headache is on the right side and the next day it is on the left?headaches are less likely of cervical origin.
(A patient with a symptomatic right knee OA or MCL sprain will not suddenly have symptoms switch into the left knee!)

2) Headaches precipitated and aggravated by certain neck postures
e.g. Prolong reading, looking down, keyboarding, turning to look behind, looking up to the top shelf of a cupboard, etc.

3) Restricted range of motion in the neck
e.g. C0-C1 and/or C1-C2 and/or C2-3 are commonly involved with cervical headaches, hence rotation is the most obvious movement that is restricted and may be painful.

Posted on: February 21, 2002


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