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  • Cephalagia
  • Headache
  • Tension headache
  • Myogenic headache

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  • 307.81 Tension headache
  • 339 Other headache syndromes
  • 339.1 Tension type headache
  • 339.2 Post-traumatic headache
  • 339.8 Other specified headache syndromes

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  • G44.209 Tension-type headache, unspecified, not intractable
  • G44.309 Post-traumatic headache, unspecified, not intractable
  • G44.81 Hypnic headache
  • G44.82 Headache associated with sexual activity
  • G44.83 Primary cough headache
  • G44.84 Primary exertional headache
  • G44.85 Primary stabbing headache
  • G44.89 Other headache syndrome

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Description

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  • Pain in the head or neck region
  • Muscular in origin
  • Squeezing feeling in the head
  • Referred pattern depending on Travell trigger points
  • Categorized as tension-type headache by the International Classification of Headache Disorders-II (ICDH-II)2
    • Migraines, tension headaches, cluster headaches and trigeminal headaches are classified as the four primary headaches
  • National Institutes of Health (NIH) 1 of 4 classifications of headaches3

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General Considerations

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  • Headaches can be harmless or disabling
  • Headaches can be a sign of something more severe in the head/brain region
  • Vision and sinus problems can cause headaches

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Demographics

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  • Can be any age group
  • Individuals that are under excess stress

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Signs and Symptoms

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  • Squeezing or tightening on head
  • Mild to moderate pain
  • Okay with routine activity

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Functional Implications

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  • Difficulty maintaining sustained sitting postures secondary to neck pain
  • Inability to sleep
  • Weakness with upper extremity lifting
  • Inability to drive or work secondary to the inability to tolerate light or sound
  • Difficulty with neck movements secondary to pain; driving

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Possible Contributing Causes

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  • Forward head rounded shoulders posture due to tight pectoralis, weak periscapular, and deep neck flexor muscles
  • Prolonged position of cervical side bending toward impaired nerve or prolonged extension
  • Facet hypertrophy
  • Trauma
  • Hydration
  • Nutritional deficiency
  • Vascular insufficiency
  • Muscular tightness
  • Stress

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Differential Diagnoses

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Imaging

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  • MRI to visualize the head/brain region
  • X-ray/Plain film radiograph helpful if osteophyte located in intervertebral foramen in cervical spine
  • CT scan

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  • To hospital for imaging of the brain and sinuses
  • To nutritionist for diet and food allergies that maybe contributing
  • To optometrist for an eye exam
  • To neurologist for nerve conduction test (EMG)

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  • Restricted mobility of the upper/mid-thoracic spine and subcranial spine
  • Hypermobile mid-cervical spine
  • Tight pectoralis major and minor
  • Weakness noted of longus colli and longus capitis
  • Weakness noted of periscapular muscles

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