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The cervical spine in tension type headache.

César Fernández-de-Las-Peñas1, Chad Cook2, Joshua A Cleland3

  • 1Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.

Musculoskeletal Science & Practice
|June 2, 2023
PubMed
Summary

The cervical spine plays a role in tension-type headaches, contributing to pain patterns but not causing them. Physical therapies targeting the neck may help manage symptoms in some individuals.

Keywords:
Cervical spineClinical reasoningExerciseManipulationManual therapyMobilizationMusculoskeletal disordersNeckSoft tissueTension-type headache

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Area of Science:

  • Neurology
  • Musculoskeletal Medicine
  • Pain Management

Background:

  • The cervical spine's role in headaches, particularly cervicogenic headache, is debated.
  • Emerging evidence suggests cervical musculoskeletal dysfunctions are also present in tension-type headache (TTH).

Purpose of the Study:

  • To review updated clinical and evidence-based data on the cervical spine's involvement in TTH.
  • To differentiate the cervical spine's role in TTH versus cervicogenic headache.

Main Methods:

  • Review of current clinical and evidence-based literature.
  • Analysis of patient presentations with TTH, including pain patterns and physical examination findings.
  • Discussion of proposed therapeutic interventions and clinical reasoning.

Main Results:

  • Individuals with TTH often exhibit neck pain, reduced cervical range of motion, and motor control issues.
  • Manual examination of cervical joints and trigger points can reproduce TTH pain.
  • The cervical spine can be a 'component' of TTH pain, not the primary 'source' as in cervicogenic headache.

Conclusions:

  • The cervical spine is implicated in TTH, contributing to the pain experience.
  • Physical therapies targeting the cervical spine may be beneficial for TTH management.
  • Distinguishing between a cervical 'component' and 'source' is crucial for accurate diagnosis and treatment.