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Arthritis of Neck and Spine and Headache
The headache associated with pain in neck including cervical spine, back side of head (occipital region) and aggravated on the movement of neck or sustained neck posture, caused by nerve, muscle or bone is also known as cervicogeneic headache. The headache is said to be associated with the dysfunction of neck, if the following conditions apply.
- The source of headache, cervical structure must be pain sensitive.
- The cervical structure should be located from where it can transfer the pain to brain through neural network.
- The cervical structure should be identifiable.
So, the headache is associated with the pain in the neck including cervical spine and back side of head (occipital region) and aggravated on the movement of neck or sustained neck posture.
Some of the symptoms associated with the neck pain and headache are as given below.
- Pain may project to forehead, eye, temples, vertex or ear.
- Patient feels limitation in neck movement or observed changes in neck muscle, counters, texture or tone or abnormal tenderness in neck muscle is observed.
- Generally the headache is absent upon awakening and progresses as the day goes on.
- Headaches are generally dull.
- Atlanto occipital or atlanto axial joint arthritis may cause recalcitrant headaches and generally observed in old age people or people suffered traumatic injury.
- The headaches may either be unilateral or bilateral in location and aggravated with neck rotation or neck extension.
He detailed symptoms can give an idea to the consulting doctor about the cause of headache. The X-Ray analysis can help identify specific problem in neck such as fracture, tumor or arthritis. MRI is also a latest technique being used for identifying specific muscle or joints related movement problems. Fluro-guided injections are also being used for accurately identifying the problems, if above techniques fails.
The various physical therapies are being used for treating cervicogenic headache and neck pain. Some of the common medication techniques are as given below.
- Manual therapy: This is a quite useful and beneficial muscle energy technique, applied without thrust for treating cervical spine joint dysfunctions. This technique is also less traumatic and less risky to the patients and is quite safe.
- Trigger point injection: There are trigger points in the upper neck and shoulder from where pain can be referred to the back of head and behind the eye. Sometimes an empty needle or needle with local anesthetic or steroids is injected to break down abnormal bands of fibrous tissues.
- C2-C3 facet joint blockade: C2-C3 joint is most vulnerable to neck pain and therefore headache associated to neck pain. The blockade helps in controlling the symptoms of neck pain and consequently headache and is done with anesthetic injections.
- Post –isometric muscle relaxation (PIMR): PIMR is an excellent and very useful technique for treating shortened muscle and myofascial pain. Muscle is isometric contracted up to the comfortable stretch barrier and then followed by stretching to a new barrier. The process is repeated and full range of motion is achieved.
- Occipital nerve block: This technique is helpful when there is a sensation or irritation in occipital nerve on one or both sides of neck. Local anesthetic ar mixture of anesthetic and carticosteroid is injected and nerve is blocked.
- Cervical traction: In cervical traction muscle, ligament or tissues are stretched and thus provide relief. This technique should not be used for conditions of cervical instability.
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