Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ CephalagiaHeadache ++ 307.81 Tension headache339 Other headache syndromes339.1 Tension type headache339.2 Post-traumatic headache339.8 Other specified headache syndromes ++ G44.209 Tension-type headache, unspecified, not intractableG44.309 Post-traumatic headache, unspecified, not intractableG44.88 Headache attributed to head and or neck trauma ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation1 +++ Description ++ Pain in the head or neck regionDysfunction in the cervical spineSuboccipitalC1-C3 vertebral regionOne of 5 National Institutes of Health (NIH) headache classifications +++ Essentials of Diagnosis ++ International Classification of Headache Disorders-II (ICHD-II) criteria2Secondary headaches are based on etiologyMay be caused by whiplash injury, intracranial headaches, neck injury, vascular disordersNIH definition for cervicogenic headacheDisorder of the cervical spine +++ General Considerations ++ Headaches can be harmless or disabling May be a sign of more severe pathology in head or brain regionSinuses and vision problems can cause headaches +++ Demographics ++ Cervical spine injury can affect any age group +++ Signs and Symptoms ++ Stiff neckLimited mobilityOne-sidedPain may radiate to arm +++ Functional Implications ++ Difficulty maintaining sitting postures secondary to neck painInability to sleepWeakness with upper extremity liftingInability to drive or work secondary to intolerance for light or soundDifficulty with neck movements (driving) secondary to pain +++ Possible Contributing Causes ++ 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 extensionFacet hypertrophyTraumaHydrationNutrition deficiencyMuscular tightnessStress +++ Differential Diagnosis ++ TumorGlaucomaSinusitisMyofascial pain syndromeRhomboid/trapezius spamsDegenerative disk diseaseLyme diseaseTemporomandibular joint dysfunctionArnold Chiari malformationMigraineheadachesCluster headachesToxic headaches +++ Imaging ++ MRI helps to visualize the head/brain region in diagnosisX-ray/plain-film radiograph helpful if osteophyte located in intervertebral foramen of cervical spineCT ++ Physical examination cluster to rule in cervical radiculopathy3Spurling’s testRotation limited to ipsilateral sideUpper limb nerve tension testDiminished brachioradialis reflex ++ To hospital for imagingTo nutritionist for dietary/nutritional counseling, evaluate for nutritional deficiencyTo optometrist for eye examinationTo neurologist for imaging ++ Restricted mobility of the upper-/mid-thoracic spine and subcranial spineHypermobile mid-cervical spineTight pectoralis major and minorNoted weakness of longus coli and longus capitusNoted weakness of periscapular muscles ++ RestHydrationJoint manipulation to the thoracic and upper cervical spineSuboccipital releaseMyofascial releaseCervical distraction and traction to relieve nerve compressionCranio-cervical flexion exercisesAddress ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth