Zervikogene Kopfschmerzen – mehr als nur „Nackenschmerzen”

 

 Buy Article Permissions and Reprints

Zusammenfassung

Kopfschmerzen sind ein häufiges, von vielen Erkrankungen hervorgerufenes Symptom. Obwohl die Manuelle Therapie in dem Ruf steht, eine Vielzahl von Kopfschmerzen behandeln zu können, trifft dies bei der gegenwärtigen Evidenzlage nur für die zervikogenen Kopfschmerzen zu. Aus diesem Grund ist die Klassifizierung der Kopfschmerzen so wichtig, da ein gutes Behandlungsergebnis nur zu erwarten ist, wenn die Behandlung auch auf die zugrunde liegende Ursache abzielt.

Aufgrund der heterogenen Natur der Kopfschmerzpathophysiologie kann die Diagnose schwierig sein, wenn sie nur auf der Symptomatik basiert. Folglich stützt sich die Kopfschmerzdiagnostik zunächst auf die klinische Symptomatik, wobei klinische Tests zur Differenzierung von Kopfschmerzformen mit ähnlicher subjektiver Präsentation dienen. Die Untersuchung mit nachfolgender Diagnosestellung ist nicht nur zur Identifizierung von Patienten unerlässlich, für die sich Manuelle Therapie eignet, sondern auch, um eine Grundlage zur Auswahl der besten Behandlungsmethode zu schaffen.

Der vorliegende Artikel umreißt die evidenzbasierte Klassifikation der Kopfschmerzen, anhand sich diejenigen Patienten identifizieren lassen, deren Kopfschmerzen auf Manuelle Therapie ansprechen.

Abstract

Headache is a common symptom arising from a range of different disorders. Although manual therapy has been advocated to treat a variety of different forms of headache, the current evidence only supports treatment for cervicogenic headache. Therefore, classification of headache is important, as a successful outcome is only likely if intervention is targeted to the underlying cause.

Due to the diverse nature of headache pathophysiology, diagnosis may be difficult when based on symptoms alone. Consequently, classification of headache is firstly based on the symptoms with clinical testing used to differentiate headache forms with similar subjective presentations. Examination and subsequent diagnosis is essential not only to identify patients with headache where manual therapy is appropriate but also to form a basis for selection of the most appropriate treatment.

The purpose of this paper is to outline in evidence-based clinical terms, the classification of headache, so that the clinician can readily identify those patients with headache suited to manual therapy.

Literatur

• 1 Allison G T, Nagy B M, Hall T. A randomized clinical trial of manual therapy for cervico-brachial pain syndrome – a pilot study.  Man Ther. 2002;  7 95-102
  Google Scholar
• 2 Amiri M, Jull G, Bullock-Saxton J. Measuring range of active cervical rotation in a position of full head flexion using the 3 d Fastrak measurement system: An intra-tester reliability study.  Manual Therapy. 2003;  8 176-179
  Google Scholar
• 3 Amiri M, Jull G, Bullock-Saxton J et al. Cervical musculoskeletal impairment in frequent intermittent headache. Part 2: Subjects with concurrent headache types.  Cephalalgia. 2007;  27 891-898
  Google Scholar
• 4 Antonaci F, Ghirmai S, Bono G et al. Cervicogenic headache: Evaluation of the original diagnostic criteria.  Cephalalgia. 2001;  21 573-583
  Google Scholar
• 5 April C, Axinn M, Bogduk N. Occipital headaches stemming from the lateral atlanto-axial (c1 – 2) joint.  Cephalalgia. 2002;  22 15-22
  Google Scholar
• 6 Bevilaqua-Grossi D, Pegoretti K S, Goncalves M C et al. Cervical mobility in women with migraine.  Headache. 2009;  49 726-731
  Google Scholar
• 7 Bigal M E, Lipton R B. The differential diagnosis of chronic daily headaches: An algorithm-based approach.  J Headache Pain. 2007;  8 263-272
  Google Scholar
• 8 Biondi D M. Physical treatments for headache: A structured review.  Headache. 2005;  45 738-746
  Google Scholar
• 9 Blau J, MacGregor E. Migraine and the neck.  Headache. 1994;  34 88-90
  Google Scholar
• 10 Bogduk N. Cervicogenic headache: Anatomical basis and pathophysiological mechanisms.  Journal of Current Pain Headache Report. 2001;  5 382-386
  Google Scholar
• 11 Bogduk N, Govind J. Cervicogenic headache: An assessment of the evidence on clinical diagnosis, invasive tests, and treatment.  Lancet Neurol. 2009;  8 959-968
  Google Scholar
• 12 Bronfort G, Haas M, Evans R L et al. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: A systematic review and best evidence synthesis.  Spine. 2004;  4 335-356
  Google Scholar
• 13 Bronfort G, Nilsson N, Haas M et al. Non-invasive physical treatments for chronic/recurrent headache.  Cochrane Database Syst Rev. 2004;  CD001878
  Google Scholar
• 14 Bronfort G, Haas M, Evans R et al. Effectiveness of manual therapies: The U. K. evidence report.  Chiropr Osteopat. 2010;  18 3
  Google Scholar
• 15 Buzzi M, Moskowitz M. The pathophysiology of migraine: Year 2005.  Journal of Headache Pain. 2005;  6 105-111
  Google Scholar
• 16 Classification Committee of the International Headache Society . The international classification of headache disorders: 2. Aufl.  Cephalalgia. 2004;  24 (Suppl. 1) 9-160
  Google Scholar
• 17 Coskun O, Ucler S, Karakurum B et al. Magnetic resonance imaging of patients with cervicogenic headache.  Cephalalgia. 2003;  23 842-845
  Google Scholar
• 18 Dankaerts W, O’Sullivan P, Burnett A et al. Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified.  Spine. 2006;  31 698-704
  Google Scholar
• 19 Dodick D W. Pearls: Headache.  Semin Neurol. 2010;  30 74-81
  Google Scholar
• 20 Dumas J P, Arsenault A B, Boudreau G et al. Physical impairments in cervicogenic headache: Traumatic vs. Nontraumatic onset.  Cephalalgia. 2001;  21 884-893
  Google Scholar
• 21 Edeling J. Migraine and other chronic headaches. Preliminary report on experimental physical treatment.  South African Journal of Physiotherapy. 1974;  30 2-3
  Google Scholar
• 22 Edmeads J. Disorders of the neck: Cervicogenic headache. In Silberstein S D, Lipton R B, Dalessio D J, (eds) Wolff’s headache and other head pain.. Oxford: Oxford University Press; 2001
  Google Scholar
• 23 Falla D. Unravelling the complexity of muscle impairment in chronic neck pain.  Man Ther. 2004;  9 125-133
  Google Scholar
• 24 Falla D L, Jull G A, Hodges P W. Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test.  Spine. 2004;  29 2108-2114
  Google Scholar
• 25 Fernandez-de-Las-Penas C, Alonso-Blanco C, Cuadrado M L et al. Are manual therapies effective in reducing pain from tension-type headache? A systematic review.  Clin J Pain. 2006;  22 278-285
  Google Scholar
• 26 Fernandez-de-las-Penas C, Perez-de-Heredia M, Molero-Sanchez A et al. Performance of the craniocervical flexion test, forward head posture, and headache clinical parameters in patients with chronic tension-type headache: A pilot study.  J Orthop Sports Phys Ther. 2007;  37 33-39
  Google Scholar
• 27 Fishbain D A, Cutler R, Cole B et al. International headache society headache diagnostic patterns in pain facility patients.  Clin J Pain. 2001;  17 78-93
  Google Scholar
• 28 Fleming R, Forsythe S, Cook C. Influential variables associated with outcomes in patients with cervicogenic headache.  J Man Manip Ther. 2007;  15 155-164
  Google Scholar
• 29 Fredriksen T A, Fougner R, Tangerud A et al. Cervicogenic headache. Radiological investigations concerning head/neck.  Cephalalgia. 1989;  9 139-146
  Google Scholar
• 30 Goadsby P J, Charbit A R, Andreou A P et al. Neurobiology of migraine.  Neuroscience. 2009;  161 327-341
  Google Scholar
• 31 Haanpaa M L, Backonja M M, Bennett M I et al. Assessment of neuropathic pain in primary care.  Am J Med. 2009;  122 (Suppl 10) S13-S21
  Google Scholar
• 32 Haas M, Schneider M, Vavrek D. Illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headache.  Chiropr Osteopat. 2010;  18 9
  Google Scholar
• 33 Haas M, Spegman A, Peterson D et al. Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: A pilot randomized controlled trial.  Spine J. 2010;  10 117-128
  Google Scholar
• 34 Hagen K, Einarsen C, Zwart J A et al. The co-occurrence of headache and musculoskeletal symptoms amongst 51 050 adults in Norway.  Eur J Neurol. 2002;  9 527-533
  Google Scholar
• 35 Haldeman S, Dagenais S. Cervicogenic headaches: A critical review.  Spine J. 2001;  1 31-46
  Google Scholar
• 36 Halim W, Chua N H, Vissers K C. Long-term pain relief in patients with cervicogenic headaches after pulsed radiofrequency application into the lateral atlantoaxial (c1-2) joint using an anterolateral approach.  Pain Pract. 2010;  10 267-271
  Google Scholar
• 37 Hall T, Elvey R L. Management of mechanosensitivity of the nervous system in spinal pain syndromes. In Boyling G, Jull G, (eds) Grieve’s modern manual therapy.. 3rd ed. New York: Churchill Livingstone; 2004
  Google Scholar
• 38 Hall T, Robinson K. The flexion-rotation test and active cervical mobility – a comparative measurement study in cervicogenic headache.  Manual Therapy. 2004;  9 197-202
  Google Scholar
• 39 Hall T, Chan H T, Christensen L et al. Efficacy of a C 1-C2 self-sustained natural apophyseal glide (snag) in the management of cervicogenic headache.  J Orthop Sports Phys Ther. 2007;  37 100-107
  Google Scholar
• 40 Hall T, Briffa K, Hopper D. Clinical evaluation of cervicogenic headache: A clinical perspective.  J Man Manip Ther. 2008;  16 73-80
  Google Scholar
• 41 Hall T M, Robinson K W, Fujinawa O et al. Intertester reliability and diagnostic validity of the cervical flexion-rotation test.  J Manipulative Physiol Ther. 2008;  31 293-300
  Google Scholar
• 42 Hall T, Elvey R L. Evaluation and treatment of neural tissue pain disorders. In Donatelli R, Wooden M, (eds) Orthopaedic physical therapy.. 4th ed. New York: Churchill Livingstone; 2009
  Google Scholar
• 43 Hall T, Briffa K, Hopper D. The influence of lower cervical joint pain on range of motion and interpretation of the flexion-rotation test.  J Man Manip Ther. 2010;  18 126-131
  Google Scholar
• 44 Hall T, Briffa K, Hopper D et al. Comparative analysis and diagnostic accuracy of the cervical flexion-rotation test.  J Headache Pain. 2010;  11 391-397
  Google Scholar
• 45 Hall T, Briffa K, Hopper D et al. Long-term stability and minimal detectable change of the cervical flexion-rotation test.  J Orthop Sports Phys Ther. 2010;  40 225-229
  Google Scholar
• 46 Hall T, Briffa K, Hopper D et al. Reliability of manual examination and frequency of symptomatic cervical motion segment dysfunction in cervicogenic headache.  Man Ther. 2010;  15 542-546
  Google Scholar
• 47 Hall T, Briffa K, Hopper D et al. The relationship between cervicogenic headache and impairment determined by the flexion-rotation test.  J Manipulative Physiol Ther. 2010;  33 666-671
  Google Scholar
• 48 Harpole L H, Samsa G P, Matchar D B et al. Burden of illness and satisfaction with care among patients with headache seen in a primary care setting.  Headache. 2005;  45 1048-1055
  Google Scholar
• 49 Henry P, Dartigues J, Puymirat C et al. The association cervicalgia-headaches: An epidemiologic study.  Cephalalgia. 1987;  7 (Suppl 6) 189-190
  Google Scholar
• 50 International Headache Society . The international classification of headache disorders: 2nd ed.  Cephalalgia. 2004;  24 (Suppl.) 1 9-160
  Google Scholar
• 51 Jensen S. Neck related causes of headache.  Aust Fam Physician. 2005;  34 635-639
  Google Scholar
• 52 Jull G, Bogduk N, Marsland A. The accuracy of manual diagnosis for cervical zygapophyseal joint pain syndromes.  Medical Journal of Australia. 1988;  148 233-236
  Google Scholar
• 53 Jull G, Zito G, Trott P et al. Inter-examiner reliability to detect painful upper cervical joint dysfunction.  Australian Journal of Physiotherapy. 1997;  43 125-129
  Google Scholar
• 54 Jull G, Barrett C, Magee R et al. Further clinical clarification of the muscle dysfunction in cervical headache.  Cephalalgia. 1999;  19 179-185
  Google Scholar
• 55 Jull G, Trott P, Potter H et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache.  Spine. 2002;  27 1835-1843
  Google Scholar
• 56 Jull G, Niere K. The cervical spine and headache. In Boyling G, Jull G, (eds) Grieve’s modern manual therapy.. 3rd ed. New York: Churchill Livingstone; 2004
  Google Scholar
• 57 Jull G A, Stanton W R. Predictors of responsiveness to physiotherapy management of cervicogenic headache.  Cephalalgia. 2005;  25 101-108
  Google Scholar
• 58 Jull G, Amiri M, Bullock-Saxton J et al. Cervical musculoskeletal impairment in frequent intermittent headache. Part 1: Subjects with single headaches.  Cephalalgia. 2007;  27 793-802
  Google Scholar
• 59 Kirchmann M. Migraine with aura: New understanding from clinical epidemiologic studies.  Curr Opin Neurol. 2006;  19 286-293
  Google Scholar
• 60 Landtblom A M, Fridriksson S, Boivie J et al. Sudden onset headache: A prospective study of features, incidence and causes.  Cephalalgia. 2002;  22 354-360
  Google Scholar
• 61 Li C, Zhang X L, Ding H et al. Comparative study on effects of manipulation treatment and transcutaneous electrical nerve stimulation on patients with cervicogenic headache.  Journal of Chinese Integrative Medicine. 2007;  5 403-406 DOI: 10.3736 /jcim20070408
  Google Scholar
• 62 Martelletti P, Steiner T J, Bertolote J M et al. The definitive position of headache among the major public health challenges. An end to the slippery slope of disregard.  J Headache Pain. 2007;  8 149-151
  Google Scholar
• 63 McDonnell M, Sahrmann S, Van Dillen L. A specific exercise program and modification of postural alignment for the treatment of cervicogenic headache: A case report.  Journal of Orthopaedic & Sports Physical Therapy. 2005;  35 3-15
  Google Scholar
• 64 Moeller J J, Kurniawan J, Gubitz G J et al. Diagnostic accuracy of neurological problems in the emergency department.  Can J Neurol Sci. 2008;  35 335-341
  Google Scholar
• 65 Nicholson G G, Gaston J. Cervical headache.  Journal of Orthopaedic & Sports Physical Therapy. 2001;  31 184-193
  Google Scholar
• 66 Nilsson N. The prevalence of cervicogenic headache in a random population sample of 20–59 year olds.  Spine. 1995;  20 1884-1888
  Google Scholar
• 67 Ogince M, Hall T, Robinson K. The diagnostic validity of the cervical flexion-rotation test in c1 / 2 related cervicogenic headache.  Manual Therapy. 2007;  12 256-262
  Google Scholar
• 68 Oksanen A, Metsahonkala L, Viander S et al. Strength and mobility of the neck-shoulder region in adolescent headache.  Physiother Theory Pract. 2006;  22 163-174
  Google Scholar
• 69 Olesen J. Are headache disorders caused by neurobiological mechanisms?.  Curr Opin Neurol. 2006;  19 277-280
  Google Scholar
• 70 Pfaffenrath V, Kaube H. Diagnostics of cervicogenic headache.  Functional Neurology. 1990;  5 159-164
  Google Scholar
• 71 Von Piekartz H J, Schouten S, Aufdemkampe G. Neurodynamic responses in children with migraine or cervicogenic headache versus a control group. A comparative study.  Man Ther. 2007;  12 153-160
  Google Scholar
• 72 Robertson B A, Morris M E. The role of cervical dysfunction in migraine: A systematic review.  Cephalalgia. 2008;  28 474-483
  Google Scholar
• 73 Roth J K, Roth R S, Weintraub J R et al. Cervicogenic headache caused by myofascial trigger points in the sternocleidomastoid: A case report.  Cephalalgia. 2007;  27 375-380
  Google Scholar
• 74 Sandmark H, Nisell R. Validity of five common manual neck pain provocation tests.  Scandinavian Journal of Rehabilitation Medicine. 1995;  27 131-136
  Google Scholar
• 75 Schäfer A, Hall T M, Briffa K. Classification of low back related leg pain – a proposed pathomechanism-based approach.  Manual Therapy. 2009;  14 222-230
  Google Scholar
• 76 Schäfer A, Hall T M, Briffa K et al. QST profiles of subgroups of patients with low back related leg pain – do they differ?. Paper presented at the International Association for the Study of Pain, Glasgow, 2008
  Google Scholar
• 77 Schäfer A, Hall T M, Lüdtke K et al. Interrater reliability of a new classification system for patients with neural low back-related leg pain.  J Man Manip Ther. 2009;  17 109-117
  Google Scholar
• 78 Schäfer A, Hall T, Muller G et al. Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: A prospective cohort study.  Eur Spine J. 2010;  (Epub ahead of print)
  Google Scholar
• 79 Sjaastad O, Fredriksen T A, Pfaffenrath V. Cervicogenic headache: Diagnostic criteria.  Headache. 1990;  30 725-726
  Google Scholar
• 80 Sjaastad O, Fredriksen T A, Pfaffenrath V. Cervicogenic headache: Diagnostic criteria. The cervicogenic headache international study group.  Headache. 1998;  38 442-445
  Google Scholar
• 81 Sjaastad O, Fredriksen T, Pareja J et al. Co-existence of cervicogenic headache and migraine without aura(?).  Functional Neurology. 1999;  14 209-218
  Google Scholar
• 82 Sjaastad O, Bakketeig L S. Migraine without aura: Comparison with cervicogenic headache. Vaga study of headache epidemiology.  Acta Neurol Scand. 2008;  117 377-383
  Google Scholar
• 83 Sjaastad O, Bakketeig L S. Prevalence of cervicogenic headache: Vaga study of headache epidemiology.  Acta Neurol Scand. 2008;  117 173-180
  Google Scholar
• 84 Smith K, Hall T, Robinson K. The influence of age, gender, lifestyle factors and sub-clinical neck pain on cervical range of motion.  Manual Therapy. 2008;  13 552-559
  Google Scholar
• 85 Smith A, O’Sullivan P, Straker L. Classification of sagittal thoraco-lumbo-pelvic alignment of the adolescent spine in standing and its relationship to low back pain.  Spine. 2008;  33 2101-2107
  Google Scholar
• 86 Steiner T J. Lifting the burden: The global campaign against headache.  Lancet Neurol. 2004;  3 204-205
  Google Scholar
• 87 Stochkendahl M, Christensen H, Hartvigsen J et al. Manual examination of the spine: A systematic review of reproducibility.  Journal of Manipulative & Physiological Therapeutics. 2006;  29 475-485
  Google Scholar
• 88 Stovner L, Hagen K, Jensen R et al. The global burden of headache: A documentation of headache prevalence and disability worldwide.  Cephalalgia. 2007;  27 193-210
  Google Scholar
• 89 Van Suijlekom H A, Lame I, Stomp-Berg S G et al. Quality of life of patients with cervicogenic headache: A comparison with control subjects and patients with migraine or tension-type headache.  Headache. 2003;  43 1034-1041
  Google Scholar
• 90 Takasaki van den H, Hall T, Oshiro S et al. Normal kinematics of the upper cervical spine during the flexion-rotation test – in vivo measurements using magnetic resonance imaging.  Man Ther. 2010;  . (Epub ahead of print)
  Google Scholar
• 91 Treleaven J, Jull G, Atkinson L. Cervical musculoskeletal dysfunction in post-concussional headache.  Cephalalgia. 1994;  14 273-279
  Google Scholar
• 92 Vincent M. Validation of criteria for cervicogenic headache.  Funct Neurol. 1998;  13 74-75
  Google Scholar
• 93 Vincent M B, Luna R A. Cervicogenic headache: A comparison with migraine and tension-type headache.  Cephalalgia. 1999;  19 (Suppl 25) 11-16
  Google Scholar
• 94 Watson D H, Trott P H. Cervical headache: An investigation of natural head posture and upper cervical flexor muscle performance.  Cephalalgia. 1993;  13 272-284; discussion: 232
  Google Scholar
• 95 World Health Organization (WHO) .World Health Report 2001. Geneva: WHO; 2001
  Google Scholar
• 96 Yi X, Cook A J, Hamill-Ruth R J et al. Cervicogenic headache in patients with presumed migraine: Missed diagnosis or misdiagnosis?.  J Pain. 2005;  6 700-703
  Google Scholar
• 97 Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache.  Manual Therapy. 2006;  11 118-129
  Google Scholar
• 98 Zusman M. Mechanisms of peripheral neuropathic pain: Implications for musculoskeletal physiotherapy.  Physical Therapy Reviews. 2008;  13 313-323
  Google Scholar
• 99 Zwart J A. Neck mobility in different headache disorders.  Headache. 1997;  37 6-11
  Google Scholar

Toby Hall

School of Physiotherapy, Curtin University

Hayman Road, Bentley

Perth

Western Australia

Email: halltm@netspace.net.au