Those with disabling neck pain are ten times more likely to experience co-morbid headaches than individuals without neck pain; and, after a motor vehicle collision, more than 80% of individuals reporting headaches also report neck pain – demonstrating how common it is for the two to occur together. The International Classification of Headache Disorders (ICHD-3) links both tension-type headaches (TTH) and cervicogenic headaches (CGH) to the cervical spine, with tension-type headaches defined as ‘typically bilateral, pressing or tightening in quality, and of mild to moderate intensity, lasting minutes to days or unremitting on average for at least three months’. TTHs do not worsen with usual physical activity, may or may not be associated with nausea, photophobia or phonophobia, and may be coupled with pericranial tenderness with palpation of the muscles of the head and neck. Cervicogenic headaches are caused by disorders in the bones, discs, and/or soft tissues of the cervical spine, and are commonly accompanied by neck pain.
Previous evidence suggests that exercises for the cervical spine or manual therapy is effective for treatment of TTH or CGH. Reassurance, acupuncture, exercise, physical therapy (including massage, spinal manipulation, heat or cold, ultrasound, and electrical stimulation), and psychological interventions have been recommended for the treatment of tension-type headaches, while exercise, spinal manipulation and cervical mobilization have been recommended as treatment for cervicogenic headaches. However, these recommendations are from guidelines based on evidence from more than five years ago. Thus, the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration (led by Dr. Pierre Côté) sought to develop up-to-date clinical guidelines for non-pharmacological management of persistent headaches associated with neck pain. This is the top of the line, best-of-the-best in terms of research in this area…so read, understand, apply and enjoy!
neck pain headache
THIS WEEK'S RESEARCH REVIEW: “Non-Pharmacological Management of Persistent Headaches Associated with Neck Pain – OPTIMa Systematic Review”
This paper was published in the European Journal of Pain (in press 2019) and this Review is posted in Recent Reviews, Headache - General, Neck Pain, OPTIMa Systematic Reviews and the 2019 Archive.

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