5: Headaches Flashcards
What are some symptoms/characteristics of migraine headaches?
- Often described as pulsating or throbbing unilateral pain the last one to two days
- Accompanied by photophobia, visual disturbances, phonophobia, nausea and vomiting
- It is aggravated by physical activity
- Sufferers will generally want to lie down in a dark quiet space
- The occurrence is occasional, not daily. However, some sufferers will have one or two a week.
- They are sometimes preceded by an aura
- Those without aura will often have some kind of prodromal syndrome such as fatigue or irritability hours to days before the onset of pain
What is a general description of cluster headaches?
- An unrelenting cluster of headaches of varying duration
- They are infrequent and affect males more than females
- They occur over weeks to months followed by periods of remission (remission could be months to years)
- May spontaneously stop
- Mechanism is unknown
- Often confused with dental or sinus problems
What are some symptoms characteristics of cluster headaches?
- Severe, unrelenting, unilateral pain
- Location varies
- House rapid onset that builds to a peak in 10 to 15 minutes
- Lasts 15 to 180 minutes
- No aura
Often associated with:
- Conjunctival redness
- Lacrimation
- Nasal congestion
- visual impairment
- Ptosis
- Palpebral edema
- Forehead/facial perspiration
How can chronic daily headache be described?
- Syndrome, not a diagnosis, with a number of subcategories
- Categorized by patient having a headache for 15+ days/month for at least three months
- Can be primary or secondary headache
- Can be debilitating and interfere with ADLs
What are symptoms and causes of sinus headaches?
- Pain occurs in sinus region, often in the infraorbital region and upper teeth
- Tends to worsen with forward bending or lying down – positioning in prone may be painful
- Caused by sinus congestion and mucosal inflammation
What’s a cervicogenic headache?
Headache as a result of joint dysfunction in the cervical spine. Facet irritation of C2-C3 can refer pain to the back of the head.
- Will present secondarily to next/shoulder pain
- Treating cervical impairment should decrease headache pain
What’s a tension headache?
Headache as a result of compression of surrounding structures (nerves, vasculature) due to increased muscle resting tension and/or trigger points
- We’ll present secondarily to neck/shoulder pain and tightness
- Most common type of headache
- Increased prevalence in women
- Individual severity and duration
- Can be frequent, episodic, chronic
- If caused by trigger points, pain will be in typical referral pattern
What are red flags, concerning headaches, that would require a referral to physician?
- This is either the first or worst headache they have ever experienced
- Reports sharp pain or spikes in intensity
- A change in personality or behaviour
- Headache worse with coughing or straining
- Neurological signs and symptoms
- Loss of consciousness, nosebleed
- Headache post head trauma
What is bruxism?
Grinding teeth excessively
How is TMJ dysfunction linked to neck pain (in some circumstances)?
- Patients with neck pain respond by bruxing, which may lead to muscular or TMJ pain
- Hey forward posture resulting in retraction of the mandible, which places the anterior throat muscles in a lengthened position ==> increased activity in muscles the close the jaw take to counter in the mandibular depression caused by digastric muscles
- Extension of the upper cervical spine places muscles and soft tissue in suboccipital region in a shortened position ==> increased MRT, trigger points, adhesions
- The nerves and joints in the upper cervical region can also become compressed or irritated
