Abstract
The most prevalent primary headaches tension-type headache and migraine are frequently associated with neck pain. A wide variety of treatment options is available for people with headache and neck pain. Some of these interventions are recommended in guidelines on headache: self-management strategies, pharmacological and non-pharmacological interventions. Physical treatment is a frequently applied treatment for headache. Although this treatment for headache is predominantly targeted on the cervical spine, the neurophysiological background of this intervention remains unclear. Recent knowledge from neuroscience will enhance clinical reasoning in physical treatment of headache. Therefore, we summarize the neuro- anatomical and—physiological findings on headache and neck pain from experimental research in both animals and humans. Several neurophysiological models (referred pain, central sensitization) are proposed to understand the co-occurrence of headache and neck pain. This information can be of added value in understanding the use of physical treatment as a treatment option for patients with headache and neck pain.
Highlights
Headache causes substantial pain and disability in people’s daily life and delivers a high burden and cost to society that is estimated only in Europe at 173 billion Euro per year [1]
We further present the relation of cervical spine dysfunction and headache and research on modulation of nociception at the trigemino-cervical complex (TCC)
In the last decades experimental research in both animals and humans on neuro-anatomy and neuro-physiology has contributed to understand the co-occurrence of headache and neck pain. Based on this information we further present a neurophysiological background for physical treatment of headache and neck pain
Summary
Headache causes substantial pain and disability in people’s daily life and delivers a high burden and cost to society that is estimated only in Europe at 173 billion Euro per year [1]. A combination of treatment options is often used, and the combination of pharmacological (acute and prophylactic drugs) and non-pharmacological (education, physical therapies, exercises, biofeedback) interventions is considered to be an efficient approach in headache disorders [10]. New insights have emerged on the relation between extracranial input from the (upper) cervical spine and headache from experimental research in both animals and humans [13]. This recent information can be of great value to understand and to (re)design physical approaches for different types of headache in combination with neck pain. We describe physical treatment as an option to treat headache and neck pain
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