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Related Concept Videos

Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Exploring Pain Phenotyping in Cervicogenic Headache Management.

Michael Cropes1, Albojay Deacon2, Evan O Nelson3

  • 1Department of Family Medicine and Community Health, School of Medicine and Public Health, Doctor of Physical Therapy Program, University of Wisconsin-Madison, Madison, WI, USA. cropes@pt.wisc.edu.

Current Pain and Headache Reports
|December 13, 2025
PubMed
Summary

Pain phenotyping for cervicogenic headache (CGH) can improve treatment precision by identifying nociceptive and nociplastic pain mechanisms. This approach guides tailored interventions for better patient outcomes in CGH management.

Keywords:
Pain mechanismsPain phenotypingQuantitative sensory testingRehabilitation

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Area of Science:

  • Neurology
  • Pain Medicine
  • Clinical Research

Background:

  • Cervicogenic headache (CGH) intervention trials show varied results, suggesting diverse underlying pain mechanisms.
  • Pain phenotyping, classifying patients by predominant pain mechanism, could enable more targeted CGH treatments.

Purpose of the Study:

  • To explore the role of pain phenotyping in managing cervicogenic headache.
  • To provide evidence-based recommendations for CGH pain phenotyping and stratified treatment.

Main Methods:

  • Systematic review of clinical evidence on CGH pain mechanisms and treatment responses.
  • Analysis of studies supporting nociceptive and nociplastic pain classifications in CGH.
  • Synthesis of treatment recommendations based on identified pain phenotypes.

Main Results:

  • Two primary CGH pain mechanisms identified: nociceptive and nociplastic.
  • Specific treatments recommended for each phenotype: muscle relaxants and spinal manipulation for both; antidepressants for nociplastic; injections/denervation for nociceptive; neuromodulation for persistent nociplastic.
  • Educational interventions for lifestyle factors are beneficial for nociplastic CGH.

Conclusions:

  • Pain phenotyping offers a strategy for more precise clinical management of cervicogenic headache.
  • Further prospective studies are necessary to confirm the impact of phenotyping on CGH clinical outcomes.