Lesser-known patient-reported symptoms arising from the upper cervical spine - A scoping review

The aims of this scoping review were to (1) describe patient-reported symptoms and (2) identify the potential mechanisms for the development of these symptoms in people with lesser-known upper cervical spine disorders to inform potential neuro-musculoskeletal management METHODS: PubMed, Cinahl, Embase, Cochrane, Scopus and Web of Science databases were searched using predefined terms. Randomised control trials, observational studies and case studies were included in this review. Two reviewers independently screened titles, abstracts and full texts, and data was extracted into a charting table. Descriptive statistics were performed RESULTS: Ninety-nine cases from 66 studies were reviewed. Patient-reported symptoms were grouped into 16 location-specific sites. Although head and neck pain were most common, 14 other symptom groups were identified. Most symptoms appeared to be related to central nervous system structures (79 %), primarily lower cranial nerves and spinal cord. The remaining 21 % of patient symptoms appeared primarily to be related to the neurovascular structures around the styloid process and the C2 spinal nerve, impacted by changes in the upper cervical joints CONCLUSIONS: The findings of this review will educate clinicians about a wide range of potential diagnoses and help them to comprehend the full spectrum of patient-reported symptoms associated with the upper cervical spine, thus improving practice. This information underscores the importance of clinicians inquiring about atypical symptoms not usually associated with musculoskeletal issues.