What is the most frequent type of headache?
Tension, 80%
2ndard causes of HA
If someone says they are having the WORST HEADACHE OF THEIR LIFE what should you think?
Subarachnoid Hemorrhage
If there is new onset focal neurological weakness think?
Stroke
If there is NEW ONSET OF HA at >50yo think?
Temporal Arthritis, Neoplasm
If there are associated systemic symptoms with HA think?
Meningitis, Encephalitis
If there is ACUTE EYE PAIN?
Hypertensive Emergency or pregnant think preeclampsia
All 2ndary causes of HA are considered?
Medical Emergencies!!!
- What are things to consider with OLDCAAARTS and HA?
a. Unilateral vs bilateral, radiation, type of pain, photosensitive or not, aura, tearing sensation, does it happen at the same time
What is the pain pattern for tension HA?
a. Bilateral Tight/achy pain, tender, Radiates from occipital/cervical region
What causes Tension type HA?
Do not know for sure, possible Trigeminal Cervical Complex, could be due to what 3 things?
b. Myofacial referred pain (trigger point), cervical Facet referral, or TMJ Dysfunction
How do you treat Tension HA due Myofascial pain conservatively?
a. Manual Manipulation Ischemic compression, i.e. treat Trigger point by smashing it
PT, Spray and stretch it or dry needles, Injections can be used?
b. Lidcaine/ steroid, oral agents
Muscle Relaxers, NSAIDS`
How can you prevent Tension type HA?
a. SSRI’s, TCA’s
What is an important behavioral modification to reducing the number of tension HAs?
Smoking Cessation
What are the 3 primary causes to TMJ headaches?
• Malocclusion (teeth lining up) , Mohammad asked this what help Malocculsion? Bite Splint
Disc displacement/Jt degeneration
Myalgia
What are 4 pain generators for TMJ joint?
- Intra-articular TMJ joint, wow the joint itself, thank you
- Extra-articular Pterygoid m, Temporalis M and Masseter M.
What are some characteristics of migraines?
a. Pain is unilateral, can shift, has multiple phases, associated symptom of nausea is most predictive
What are the common triggers of Migraines?
a. Emotional stress, hormones (esp. Female), irregular sleep, diet, Caffiene, Alcohol, changes in weather, dehyradtion, smells, medication
If a HA comes around the same time every day and is always relieved by taking the same medication, then it is a …?
Medication Overuse/Rebound HA
- How do you treat medication Rebound HA?
a. Stop the dang drug, can use different one to bridge pain, NO OMT!!!!
What are the TWO HA that you CANNOT use OMT for?
Cluster and Medication Rebound
