Headaches

Question 1

Causes of ACUTE HA pain

Answer 1

• Trauma
  
  • concussion
  • blunt trauma to upper CS, face, TMJ, head
  • whiplash
• Acute infection (ex. meningitis)
• Fever (flu, COVID, etc.)
• CVA
• Subarachnoid hemorrhage
• Rupture of brain aneurysm
• Brain tumor (could also cause chronic pain***)
• HTN
• Caffeine w/drawal

*NOTE: bolded text all related to brain

Question 2

Location as a clue to the type or cause

*Forehead

Answer 2

• sinusitis
• suboccipital muscle spasm
• eye disorders
• ear disorders

Question 3

Location as a clue to the type or cause

*Side of Head

Answer 3

• Migraine
• Eye or ear disorder
• Auriculotemporal neuralgia

Question 4

Location as a clue to the type or cause

*Top of Head (Parietal)

Answer 4

• Meningitis
• Psychiatric disorders

Question 5

Location as a clue to the type or cause

*Occipital

Answer 5

• Muscle tension/myofascial disorders
• Upper C/S disorders
• Subocc. mm spasms

Question 6

Location as a clue to the type or cause

*Face

Answer 6

• TMJ
• Trigeminal Neuralgia (tic douloureux)
  
  • *trigeminocervical complex→ C1, C2, C3
• Upper C/S disorders
  
  • same reason as TMJ (closely related!)

Question 7

Location as a clue to the type or cause

*Ram’s Horn Distribution

Answer 7

• Cervical and/or trapz muscle tension

Question 8

Recurrent and/or Chronic HAs

*Common Types

Answer 8

• Migraines
• Cluster
• Sinus
• Cervicogenic
  
  • remember Mulligan HA Snag or upper C/S jts***** see lab notes
• TMJ-related
  
  • orofacial pain around TMJ or upper C/S

Question 9

Recurrent and/or Chronic HAs

*Common Types

*More on Cervicogenic

Answer 9

• Tension→ mm tension and/or trigger pts
• Atlanto-occipital joint (O-A joint) and/or Atlantoaxial joint (C1-C2, upper cervical jts)

**Mulligan HA Snag→ see lab notes!

Question 10

Migraines

**U/L!!!

FACTS:

Answer 10

• > prevalence in females 20-40yo
• Aura→ know migraine is coming on
• Builds to throbbing/intense
• Usually Unilateral***
• Sensitivity to light/sounds
• Nausea/vom
• Irritable/mood disturbs
• Lasts hours to days
• Vasomotor cause
  
  • blood flow + regulation of bloodflow thru brain
• Precipitation factors:
  
  • phys. exertion
  • emotional stress
  • hormonal
  • dietary

Question 11

Cluster (Histamine) HA

Answer 11

• More prevalent in Males 20-40yo
• Severe, stabbing, burning, pulsating
• Unilateral around Eye***
• 1-4 episodes over 24hrs
  
  • Why its called “Cluster HA”
• Usually @ night; sleep disturbs
• Other Sxs:
  
  • Ipsilateral face sweating, lacrimation, congestion, rhinorrhea
• Vasomotor cause
  
  • blood flow thru vessels

Question 12

Sinus HA

Answer 12

• Dull, persistent pain in front of face
• Face, ear and/or nose
• Variable duration
• Caused by congestion, blockage, infection

Question 13

Cervicogenic HA’s

2 Reasons:

Answer 13

1. Tension HA
2. Upper C/S Disorders

Question 14

Cervicogenic HA

*Tension HA

Answer 14

*Think Ram’s Head Pattern

Tension in…

• CS mm’s
• Suboccipital mm’s
• Trapz

Question 15

Cervicogenic HA

*Upper C/S Disorders

Answer 15

• Can also cause orofacial pain similar to that seen w/ TMD, due to trigeminal-cervical complex

Question 16

Cervicogenic HA: Interventions

Tension HA (CS muscles/Trapz)

*get muscles to RELAX!

Answer 16

• Heat
• Massage/STM/IASTM
• Relaxation tech’s
• Supported rest (pillows)
  
  • bc when upright the C/S mms are working due to flexion moment on head→ constant postural tone
• Meds
  
  • NSAIDS or Tylenol
  • Antidepressants
  • Anticonvulsants
  • MM relaxers

Question 17

Cervicogenic HA: Interventions

*Upper C/S Disorders

Answer 17

• Address any muscular components (like from Tension Cervicogenic HA)
• Postural correction*
• Upper C/S Manual Tx
  
  • O-A release
  • Mulligan HA Snag (see lab notes) OR Reverse HA Snag